Key result
Metoprolol combined with torasemide significantly increased the total clinical efficacy rate to 97.01% compared to 83.87% with metoprolol alone in elderly patients with degenerative valvular heart disease and heart failure.
Why the study?
The clinical efficacy of metoprolol combined with torasemide and its effect on NT-proBNP concentrations in elderly patients with degenerative valvular heart disease and heart failure required investigation.
Does metoprolol combined with torasemide improve cardiac function and reduce NT-proBNP in elderly patients with degenerative valvular heart disease and heart failure?
Cohort (n=129)
No
Does metoprolol combined with torasemide improve cardiac function and reduce NT-proBNP in elderly patients with degenerative valvular heart disease and heart failure?
Absolute Event Rate: 97.01% vs 83.87%
p-value: p=0.024
In elderly patients with degenerative valvular heart disease and heart failure, adding torasemide to metoprolol for one week significantly improved cardiac function and reduced NT-proBNP and inflammatory markers compared to metoprolol alone.
May support adjunctive torasemide in elderly valvular HF; hypothesis-generating and requires RCT confirmation before practice change.
Objective: To investigate the efficacy of metoprolol combined with torasemide in elderly patients with degenerative valvular heart disease (DVHD) and heart failure and its influence on N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations. Methods: The records of 129 DVHD patients ≥60 years old with heart failure diagnosed and treated in our hospital from January 2020 to February 2022 were retrospectively selected. According to the treatment records, 62 patients received metoprolol treatment (Control-group), and 67 patients received metoprolol combined with torasemide treatment (Observation-group). The changes in cardiac function, NT-proBNP and inflammatory factor concentrations and clinical efficacy were analyzed and compared between the two groups before and after treatment. Results: After treatment, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and the mitral ratio of peak early to late diastolic filling velocity (E/A) were lower, with a greater decrease in the Observation-group compared to the Control-group (P<0.05). After treatment, NT-proBNP and interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6) concentrations were lower in both groups, with a greater decrease in the Observation-group compared to the Control-group (P<0.05). The total clinical efficacy of the Observation-group was significantly higher than the Control-group (P<0.05). There was no significant difference in the total incidence of adverse drug reactions between the two groups (P>0.05). Conclusion: Metoprolol combined with torasemide has a significant therapeutic effect on DVHD patients with heart failure. This drug combination improved cardiac function, reduced NT-proBNP concentrations and has good safety. doi: https://doi.org/10.12669/pjms.39.4.7465 How to cite this: Ren K, Feng J, Yang X, Ren B, Guo Y. Efficacy of metoprolol combined with torasemide in elderly patients with degenerative valvular heart disease and heart failure and its influence on NT-proBNP levels. Pak J Med Sci. 2023;39(4):945-949. doi: https://doi.org/10.12669/pjms.39.4.7465 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Ren et al. (2023) conducted a cohort in Degenerative valvular heart disease and heart failure (n=129). Metoprolol combined with torasemide vs. Metoprolol alone was evaluated on Total clinical efficacy rate (p=0.024). Metoprolol combined with torasemide significantly increased the total clinical efficacy rate to 97.01% compared to 83.87% with metoprolol alone in elderly patients with degenerative valvular heart disease and heart failure.
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