Carvedilol and Cardiac Biomarkers in Dialysis Patients: Secondary Analysis of a Randomized Controlled Trial

• Published in: Kidney & blood pressure research Vol. 42; no. 6; pp. 1033 - 1044
• Main Authors: Roberts, Matthew A., Darssan, Darsy, Badve, Sunil V., Carroll, Robert P., Fahim, Magid A., Haluska, Brian A., Hawley, Carmel M., Isbel, Nicole M., Marshall, Mark R., Pascoe, Elaine M., Pedagogos, Eugenie, Pilmore, Helen L., Snelling, Paul, Stanton, Tony, Tan, Ken-Soon, Tonkin, Andrew M., Vergara, Liza A., Ierino, Francesco L.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger Publishers 01-01-2017
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Adult; Aged; Beta-adrenergic receptor blocker; Biomarkers - blood; Carbazoles - pharmacology; Carbazoles - therapeutic use; Cardiac biomarkers; Cardiovascular; Dialysis; Echocardiography; Female; Heart Diseases - diagnosis; Heart Diseases - etiology; Humans; Male; Middle Aged; Natriuretic Peptide, Brain - blood; Natriuretic Peptide, Brain - drug effects; Original Paper; Peptide Fragments - blood; Peptide Fragments - drug effects; Propanolamines - pharmacology; Propanolamines - therapeutic use; Randomized controlled trial; Renal Insufficiency, Chronic - complications; Troponin T - blood; Troponin T - drug effects; Beta-adrenergic receptor blocker; Dialysis; Echocardiography; Cardiac biomarkers; Cardiovascular; Randomized controlled trial
• ISSN: 1420-4096; 1423-0143
• DOI: 10.1159/000485589

Background/Aims: Cardiac biomarkers are associated with cardiac abnormalities and adverse outcomes in dialysis patients. Our aim was to report the effect of the beta-blocker carvedilol on cardiac biomarkers in adult dialysis patients. Methods: The Beta-Blocker to Lower Cardiovascular Dialysis Events Feasibility Study was a randomized controlled trial comparing carvedilol to placebo. Serum and plasma were collected before the run-in, then 6 and 12 months post-randomization to measure B-type Natriuretic Peptide (BNP), N-terminal BNP (NT-ProBNP), high-sensitivity cardiac troponins I (hs-TnI) and T (hs-TnT), and galectin-3. Left ventricular global longitudinal strain (GLS) was measured by echocardiography at baseline. Results: Seventy-two participants were recruited of whom 49 completed the run-in and were randomized to carvedilol (n=26) or placebo (n=23). Baseline echocardiography demonstrated median (inter-quartile range) GLS of -14.27% (-16.63 to -11.93). NTproBNP and hs-TnT correlated with GLS (Spearman’s rho=0.34 [p=0.018] and rho=0.28 [p=0.049], respectively). Median change scores from baseline to 12 months did not differ significantly between participants with complete biomarker data randomized to carvedilol (n=15) or placebo (n=16) for any biomarkers. Conclusions: NT-proBNP and hs-TnT were associated with GLS. However, changes in levels of the biomarkers from baseline to 12 months were not different between groups randomized to carvedilol and placebo.