Effects of carvedilol or metoprolol on PAI-1, tPA-mass concentration or Von Willebrand factor in chronic heart failure - a COMET substudy
| Autor: | Torbjörn K. Nilsson, Jan-Håkan Jansson, John G.F. Cleland, Philip A. Poole-Wilson, Kurt Boman, Karl Swedberg |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Adrenergic beta-Antagonists Comet Carbazoles Tissue plasminogen activator Propanolamines Von Willebrand factor Internal medicine Plasminogen Activator Inhibitor 1 von Willebrand Factor medicine Humans Sinus rhythm cardiovascular diseases Carvedilol Aged Randomized Controlled Trials as Topic Metoprolol Heart Failure Sweden biology business.industry organic chemicals Atrial fibrillation Hematology medicine.disease Treatment Outcome Sample Size Tissue Plasminogen Activator Heart failure biology.protein Cardiology Female business human activities circulatory and respiratory physiology medicine.drug |
| Zdroj: | Thrombosis Research. 125:e46-e50 |
| ISSN: | 0049-3848 |
| Popis: | In COMET (Carvedilol or Metoprolol European Trial), carvedilol reduced mortality compared with metoprolol in patients with chronic heart failure. We hypothesized that carvedilol might have greater effects on endothelial derived haemostatic factors than metoprolol. We aimed to study the effects of carvedilol or metoprolol on tissue plasminogen activator (tPA), its inhibitor PAI-1 and Von Willebrand factor (VWF) in patients with heart failure.We recruited 260 patients (134 on carvedilol, 126 on metoprolol), mean age 66 years and 84% of them men. Plasma mass concentrations of tPA and PAI-1and percent of VWF were measured at baseline and after one and two years of treatment.Plasma tPA, PAI-1 and VWF were similar between treatment groups at baseline and no significant differences between groups emerged after one or two years of treatment. In paired analyses in patients assigned to carvedilol, median PAI-1 level decreased from 37.2 to 32.1 microg/l at two years (p=0.034) and of VWF decreased from baseline to one year (240 vs. 218%, p=0.023) in patients assigned to carvedilol but were not reduced at any time in patients assigned to metoprolol. Plasma tPA increased over time in both treatment groups (p=0.013 and 0.027 respectively).We found no significant difference in the effects of carvedilol or metoprolol on tPA, PAI-1 and VWF. Comparison over time within treatment groups suggested that PAI-1 and VWF might have declined on carvedilol but not on metoprolol. Our hypothesis is not proved but this may reflect an inadequate sample size rather than lack of an effect. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect