Clinical Impact of Bisoprolol Versus Carvedilol in Patients Undergoing Femoropopliteal Stenting

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• Aim: Beta-blockers are not considered to be contraindicated in patients with peripheral artery disease, and carvedilol and bisoprolol are commonly used in patients with PAD in Japan. Because there have been only a few reported comparative studies of the effects of different beta-blockers, we compared the clinical outcomes in patients treated with these beta-blockers after undergoing femoropopliteal stenting.Methods: Between January 2004 and December 2011, 2911 consecutive patients who had undergone their first femoropopliteal stenting were enrolled in this study. Of these patients, 438 patients(532 limbs) on carvedilol(187 patients, 229 limbs) or bisoprolol(251 patients, 303 limbs) were identified and analyzed retrospectively. The primary outcome was the primary patency and the secondary outcomes were the secondary patency and overall survival and freedom from major adverse limb events(MALE; including any repeated revascularization and major amputation), and these were compared between the groups. The mean follow-up interval of the survivors was 27±17 months.Results: The primary patency was significantly higher in the bisoprolol-treated group than in the carvedilol-treated group(82.4% vs. 73.6% at 2 years, p=0.0006) as were the secondary patency (93.5% vs. 88.1% at two years, p=0.0004) and freedom from MALE (unadjusted: 79.6% vs. 67.9% at two years, p＜0.0001). However, the two-year overall survival was similar between the groups(91.2% vs. 89.9% at two years, p=0.44). Even after adjusting for baseline differences, bisoprolol was still found to be significantly more effective for the primary patency (HR 0.56, 95% CI 0.37 to 0.83, adjusted p=0.005).Conclusion: Our retrospective study suggests that bisoprolol is associated with more favorable outcomes for vessel patency and avoidance of MALE than is carvedilol.

• 一般社団法人 日本動脈硬化学会の論文

著者

• Suematsu Nobuhiro

  Department of Bioclimatology and Medicine, Medical Institute of Bioregulation, Kyushu University

• Iida Osamu

  Cardiovascular Center Kansai Rosai Hospital

• Okazaki Shinya

  Department Of Applied Chemistry & Biochemistry Faculty Of Engineering Kumamoto University

• Tsuchiya Taketsugu

  Division of Cardiology, Kanazawa Cardiovascular Hospital

• Takahashi Hiroki

  Department Of Cardiology Pulmonology And Nephrology Yamagata University School Of Medicine

• Kawasaki Daizo

  Cardiovascular Division Department Of Internal Medicine Hyogo College Of Medicine

• Hirano Keisuke

  Department Of Applied Chemistry Graduate School Of Engineering Osaka University

• Soga Yoshimitsu

  Department Of Cardiology Hyogo Prefectural Amagasaki Hospital

• Yamaoka Terutoshi

  Department Of Surgery Matsuyama Red Cross Hospital

• Shinozaki Norihiko

  Department Of Cardiac Surgery And Cardiology Cardiovascular Center Shinonoi General Hospital

• Suzuki Kenji

  Department Of Anesthesia Kitakami Saiseikai Hospital

• Iida Osamu

  Cardiovascular Center, Kansai Rosai Hospital

• MIYASHITA Yusuke

  Department of Advanced PAD Therapeutics, Shinshu University

• Shintani Yoshiaki

  Department Cardiology, Sinkoga Hospital, Japan

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