Bisoprolol proves safer than carvedilol for patients on dialysis
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For patients receiving hemodialysis in Taiwan, bisoprolol demonstrated superior safety compared with carvedilol, according to a study of the two beta blockers.
In many health systems, bisoprolol and carvedilol are the two most commonly used [beta blockers] BBs,” Ping-Hsun Wu, MD, of Kaohsiung Medical University Hospital, and colleagues wrote. “Bisoprolol may offer advantages over carvedilol because of its beta1 selectivity and moderate dialyzability with less intradialytic hypotension potential. The objective of this study was to evaluate the risk for all-cause mortality and [cardiovascular] CV events associated with bisoprolol compared with carvedilol in [hemodialysis] HD patients.”
Including 9,305 patients who initiated bisoprolol and 11,171 patients who initiated carvedilol treatment, researchers recorded 1,555 deaths and 5,167 major adverse cardiovascular events (MACEs)within 2 years of follow-up.
“Bisoprolol initiators were younger, had shorter dialysis vintage, were women, had common comorbidities of hypertension and hyperlipidemia and were receiving statins and antiplatelets, but they had less heart failure and digoxin prescriptions than carvedilol initiators,” the researchers wrote.
Results showed bisoprolol initiation was associated with lower risks for all-cause mortality (hazard ratio [HR] = 0.66) and MACEs (HR = 0.85), while also being attributed to a lower risk for heart failure (HR = 0.83) and ischemic stroke (HR = 0.84). No differences were observed between the medications regarding risk for acute myocardial infarction (HR = 1.03).
“In the absence of trial evidence, this study may inform the choice of BB therapy in this high-CV-risk population with a void of evidence,” Wu and colleagues concluded.
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