Key result
Heart failure was associated with increased alpha-1-acid glycoprotein concentration and decreased free fraction of disopyramide compared to healthy controls.
Why the study?
Does decompensated congestive heart failure alter alpha-1-acid glycoprotein concentration and the free fraction of disopyramide compared to healthy controls and compensated cardiac patients?
Observational
Does decompensated congestive heart failure alter alpha-1-acid glycoprotein concentration and the free fraction of disopyramide compared to healthy controls and compensated cardiac patients?
In patients with decompensated congestive heart failure, elevated alpha-1-acid glycoprotein levels significantly decrease the free fraction of disopyramide, suggesting the need for frequent monitoring of free drug concentrations to avoid toxicity or subtherapeutic dosing.
Answers are grounded in this paper and cite their sources.
May support free disopyramide monitoring in decompensated HF; hypothesis-generating pending prospective outcome trials.
Alpha-1-acid glycoprotein (AAG) concentration and protein binding of disopyramide (DSP) in serum were measured in patients with heart disease. An increase in AAG (121±45mg/dl, mean±SD) was fbund in padents with heart failure as compared with healthy controls (73±14) and with cardiac patients without heart failure (78±12). The free fraction of DSP (0.35±0.12) was decreased in patients with heart failure as compared with control (0.56±0.11) and with patients without heart failure (0.47±0.15). The values of the heart failure patients returned to the level of cardiac patients with out heart failure (89±23 mg/dl and 0.48±0.07) with recovery from the decompensated stage. These findings suggest that the free concentration of DSP should be monitored frequently in cardiac patients, especially in patients with congestive heart failure.
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Nomura et al. (1994) conducted an observational in Heart disease. Heart failure vs. Healthy controls and cardiac patients without heart failure was evaluated on Alpha-1-acid glycoprotein (AAG) concentration. Heart failure was associated with increased alpha-1-acid glycoprotein concentration and decreased free fraction of disopyramide compared to healthy controls.
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