Adrenergic Receptor Polymorphisms and Prevention of Ventricular Arrhythmias With Bucindolol in Patients With Chronic Heart Failure
Key result
Bucindolol reduced ventricular tachycardia or fibrillation in heart failure patients (subhazard ratio 0.42; 95% CI 0.27-0.64; P=0.00006), with the effect modulated by adrenergic receptor polymorphisms.
Why the study?
Does bucindolol reduce ventricular tachycardia/ventricular fibrillation in patients with chronic heart failure and reduced LVEF, and is this effect modulated by adrenergic receptor polymorphisms?
Population
1,040 patients with chronic heart failure and reduced left ventricular ejection fraction from a substudy of…
Design
Cohort
Authors
Discussion
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Member takes
Implication
May reduce VT/VF in select HFrEF genotypes; hypothesis-generating and requires randomized confirmation before practice change.
Study Design
Type
RCT (n=1,040)
Structured PICO
Does bucindolol reduce ventricular tachycardia/ventricular fibrillation in patients with chronic heart failure and reduced LVEF, and is this effect modulated by adrenergic receptor polymorphisms?
P
Population
1,040 patients with chronic heart failure and reduced left ventricular ejection fraction evaluated for the effect of adrenergic receptor polymorphisms on bucindolol efficacy.
I
Intervention
Bucindolol
O
Outcome
Ventricular tachycardia/ventricular fibrillation (VT/VF) recorded as an adverse eventhard clinical
Main Result
Hazard Ratio: 0.42 (95% CI 0.27–0.64)
p-value: p=0.00006
Bucindolol reduces ventricular arrhythmias in patients with HFrEF, but this therapeutic benefit is highly dependent on β1 and α2c adrenergic receptor genetic variants.
Cite This Study
Aleong et al. (2012) conducted an RCT in chronic heart failure and reduced left ventricular ejection fraction (n=1,040). Bucindolol was evaluated on Ventricular tachycardia/ventricular fibrillation (VT/VF) (subhazard ratio 0.42, 95% CI 0.27-0.64, p=0.00006). Bucindolol reduced ventricular tachycardia or fibrillation in heart failure patients (subhazard ratio 0.42; 95% CI 0.27-0.64; P=0.00006), with the effect modulated by adrenergic receptor polymorphisms.