The β-blocker uptitration in elderly with heart failure regarding biomarker levels: CIBIS-ELD substudy

Abstract

Aim: We investigated if the baseline value of mid-regional pro-atrial natriuretic peptide (NP), N-terminal pro-B-type NP and copeptin may be helpful in optimizing β-blocker uptitration in elderly patients with heart failure.

Patients & methods: According to the biomarkers' levels, 457 patients were divided into three subgroups and compared with each other at baseline and 3 months after.

Results: All mid-regional pro-atrial NP and N-terminal pro-B-type NP subgroups had significant amelioration of left ventricle ejection fraction and New York Heart Association (NYHA) class after 3 months of β-blocker uptitration (p < 0.001). More prominent improvement of left ventricle ejection fraction and New York Heart Association class was observed in subgroups with lower versus higher NPs levels.

Conclusion: NPs levels, unlike copeptin levels, might be useful tool for objective selection of elderly heart failure patients who could have the greatest benefit of forced uptitration.

Keywords: N-terminal pro B-type natriuretic peptide; chronic heart failure; copeptin; mid-regional pro-atrial natriuretic peptide; β-blocker uptitration.