Premium
Consideration of beta‐1 adrenergic receptor polymorphisms along with traditional risk factors as predictors of prognosis in patients with heart failure
Author(s) -
Rantinella R. P.,
Zineh I.,
Potvin M. L.,
Yarandi H. N.,
Sloan A. J.,
Pauly D. F.,
Johnson J. A.
Publication year - 2004
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2003.11.208
Subject(s) - spironolactone , medicine , digoxin , heart failure , hazard ratio , population , creatinine , proportional hazards model , diabetes mellitus , cardiology , endocrinology , confidence interval , environmental health
Traditional risk factors have been linked to heart failure (HF) severity. We investigated whether β 1 ‐adrenergic receptor (AR) genotypes and variable HF drug use offer additional prognostic information. Patients with documented HF were enrolled and followed for all‐cause mortality, heart transplant, or HF hospitalization. Cox regression was used to examine the effects of covariates on outcome. Variables included traditional demographic, medical and social history, and laboratory parameters along with use of digoxin and spironolactone, β 1 AR codon 49 genotype, and β 1 AR codon 389 genotype. β‐blocker, ACE inhibitor, and diuretic use were high at baseline and end of follow‐up and not included in the model. Significance for inclusion in the model was set at 0.1. Patients (n=181) were followed for a median of 18 months (4 days min, 36 months max). Significant markers of HF prognosis are presented ( Table). HF drugs with variable use (digoxin, spironolactone) and β 1 AR genotypes were not significant. Traditional risk factors associated with worse HF prognosis were verified in our population. β 1 AR genotypes and digoxin and spironolactone use were not associated with the composite endpoint. The guideline‐driven high use of β‐blockers in this population may have masked any β 1 AR genotype effects on endpoints. Clinical Pharmacology & Therapeutics (2004) 75 , P55–P55; doi: 10.1016/j.clpt.2003.11.208Variable Hazard Ratio P‐valueSerum sodium 0.88 <0.0001 NYHA class 1.81 0.0002 Creatinine 1.04 0.004 Male gender 2.24 0.007 Dyslipidemia history 0.60 0.051 Previous CABG 1.66 0.054 Diabetes history 1.63 0.094