Kidney & Blood Pressure Research (Dec 2017)

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

  • Matthew A. Roberts,
  • Darsy Darssan,
  • Sunil V. Badve,
  • Robert P. Carroll,
  • Magid A. Fahim,
  • Brian A. Haluska,
  • Carmel M. Hawley,
  • Nicole M. Isbel,
  • Mark R. Marshall,
  • Elaine M. Pascoe,
  • Eugenie Pedagogos,
  • Helen L. Pilmore,
  • Paul Snelling,
  • Tony Stanton,
  • Ken-Soon Tan,
  • Andrew M. Tonkin,
  • Liza A. Vergara,
  • Francesco L.  Ierino

DOI
https://doi.org/10.1159/000485589
Journal volume & issue
Vol. 42, no. 6
pp. 1033 – 1044

Abstract

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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.

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