Importance of non selective beta blockade in congestive heart failure - Experiences with carvedilol treatment in Bosnia and Herzegovina

Šekib Sokolović, Alen Džubur, Edita Černi Obrdalj, Amila Hadžimuratović, Belma Kapo, Meliha Mehić, Džan Ahmed Jesenković

Abstract


Objectives: The aim of this study was to investigate the effects
of carvedilol treatment through improvement of New York
Heart Association (NYHA) class, ejection fraction (EF) and
blood pressure (BP) values in patients with chronic heart failure
(CHF).
Methods: This multicenter, observational, non-interventional
was conducted in 25 medical centers in Bosnia and Herzegovina,
from April 2015 until December 2015 (nine months). It
included 167 patients of both genders, older than 50 years, who
were diagnosed with CHF according to the NYHA classification
and had EF <50%. The patients were administered carvedilol
tablets and were followed during six visits: baseline and five
follow-ups, over the period of 24 weeks.
Results: At the beginning of the study, CHF NYHA class I was
present in 5 (3.0%) patients, NYHA class II in 76 (45.5%) and
NYHA class III in 66 (39.5%) patients. After 24 weeks, CHF
NYHA class I was present in 43 (25.7%) patients, NYHA class
II in 75 (44.9%) and NYHA class III in 21 (12.6%) patients.
There is a statistically significant change of NYHA class before
and after 24 weeks of treatment with carvedilol (rho=0.272;
p=0.002). At the baseline observation, mean value of EF was
43.06±9.6%. after 24 weeks of treatment, the mean value of
EF increased to 48.15±10.51% (p=0.0001). Average increase of
EF after the treatment was 5%, or ranging from 1.5-7.5%. Systolic
and diastolic blood pressure significantly decreased from
baseline to final observation (-15.4 mmHg and -9.18 mmHg;
p=0.0001).
Conclusion: Carvedilol is effective in improvement of NYHA
class and ejection fraction as well as in reduction of high blood
pressure in patients with congestive heart failure.
Keywords: chronic heart failure, NYHA classification, carvedilol,
treatment efficacy


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