Autor: |
Piccini, Jonathan P., Abraham, William T., Dufton, Christopher, Carroll, Ian A., Healey, Jeff S., van Veldhuisen, Dirk J., Sauer, William H., Anand, Inder S., White, Michel, Wilton, Stephen B., Aleong, Ryan, Rienstra, Michiel, Krueger, Steven K., Ayala-Paredes, Felix, Khaykin, Yaariv, Merkely, Bela, Miloradovic, Vladimir, Wranicz, Jerzy K., Ilkhanoff, Leonard, Ziegler, Paul D., Davis, Gordon, Emery, Laura L., Marshall, Debra, Kao, David P., Bristow, Michael R., Connolly, Stuart J. |
Přispěvatelé: |
Cardiovascular Centre (CVC) |
Jazyk: |
angličtina |
Rok vydání: |
2019 |
Předmět: |
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Zdroj: |
JACC. Heart failure, 7(7), 586-598. ELSEVIER SCI LTD |
ISSN: |
2213-1779 |
Popis: |
OBJECTIVES The purpose of this study was to compare the effectiveness of bucindolol with that of metoprolot sucdnate for the maintenance of sinus rhythm in a genetically defined heart failure (HF) population with atrial fibrillation (AF). BACKGROUND Bucindolol is a beta-blocker whose unique pharmacologic properties provide greater benefit in HF patients with reduced ejection fraction (HFrEF) who have the beta(1)-adrenergic receptor (ADRB1) Arg389Arg genotype. METHODS A total of 267 HFrEF patients with a left ventricular ejection fraction (LVEF) RESULTS The hazard ratio (HR) for the primary endpoint was 1.01 (95% confidence interval [CI]: 0.71 to 1.42), but trends for bucindolol benefit were observed in several subgroups. Precision therapeutic phenotyping revealed that a differential response to bucindolol was associated with the interval of time from the initial diagnoses of AF and HF to randomization and with the onset of AF relative to that of the initial HF diagnosis. In a cohort whose first AF and HF diagnoses were CONCLUSIONS Pharmacogeneticalty guided bucindolol therapy did not reduce the recurrence of AF/AFL or ACM compared to that of metoprolol therapy in HFrEF patients, but populations were identified who merited further investigation in future phase 3 trials. (C) 2019 Published by Elsevier on behalf of the American College of Cardiology Foundation. |
Databáze: |
OpenAIRE |
Externí odkaz: |
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