Bisoprolol trumps carvedilol in easing inflammation in chronic heart failure patients

Bisoprolol may be more effective than carvedilol in reducing inflammation in patients with chronic heart failure (CHF), according to a subanalysis of the BRIGHT-D* study. However, carvedilol appears to have the upper hand in reducing oxidative stress.

BRIGHT-D enrolled 87 CHF patients, of whom 48 were eligible for the present subanalysis. These patients had baseline and follow-up information regarding oxidative stress, measured through the derivatives of reactive oxygen metabolites (d-ROMs). High-sensitivity C-reactive protein (hs-CRP) was used as a marker of inflammation.

Of the participants, 26 (mean age, 58.0±14.2 years; 76.9 percent male) were taking bisoprolol while the remaining 22 (mean age, 58.7±15.0 years; 77.3 percent male) were on carvedilol medication. Baseline levels of hs-CRP were comparable between groups (3.35±0.78 vs 3.38±0.59 log (ng/mL); p=0.064).

Concentrations of hs-CRP decreased over time in both treatment arms, though the 24-week change was greater in the bisoprolol group (to 2.69±0.44 log [ng/mL]; p=0.001) than in the carvedilol group (to 2.85±0.76 log [ng/mL]; p=0.047). Nevertheless, the change value in both groups were significant.

Overall levels of d-ROMs likewise decreased in both treatment arms over time. However, as opposed to hs-CRP trends, carvedilol produced a larger drop than bisoprolol at 24 weeks (382±84 to 312±76 U.CARR; p=0.006 vs 401±106 to 344±82 U.CARR; p=0.015). Baseline concentrations were statistically similar between the treatment arms.

*Bisoprolol Improvement Group for Chronic Heart Failure Treatment Study in Dokkyo Medical University