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Consideration of beta-1 adrenergic receptor polymorphisms along with traditional risk factors as predictors of prognosis in patients with heart failure

Consideration of beta-1 adrenergic receptor polymorphisms along with traditional risk factors as predictors of prognosis in patients with heart failure

Clinical Pharmacology & Therapeutics 75(2): P55

Traditional risk factors have been linked to heart failure (HF) severity. We investigated whether β1-adrenergic receptor (AR) genotypes and variable HF drug use offer additional prognostic information.Patients with documented HF were enrolled and followed for all-cause mortality, heart transplant, or HF hospitalization. Cox regression was used to examine the effects of covariates on outcome. Variables included traditional demographic, medical and social history, and laboratory parameters along with use of digoxin and spironolactone, β1AR codon 49 genotype, and β1AR codon 389 genotype. β-blocker, ACE inhibitor, and diuretic use were high at baseline and end of follow-up and not included in the model. Significance for inclusion in the model was set at 0.1.Patients (n=181) were followed for a median of 18 months (4 days min, 36 months max). Significant markers of HF prognosis are presented (Table). HF drugs with variable use (digoxin, spironolactone) and β1AR genotypes were not significant.Traditional risk factors associated with worse HF prognosis were verified in our population. β1AR genotypes and digoxin and spironolactone use were not associated with the composite endpoint. The guideline-driven high use of β-blockers in this population may have masked any β1AR genotype effects on endpoints.Clinical Pharmacology & Therapeutics (2004) 75, P55–P55; doi: 10.1016/j.clpt.2003.11.208Table 1. VariableHazard RatioP-valueSerum sodium0.88<0.0001NYHA class1.810.0002Creatinine1.040.004Male gender2.240.007Dyslipidemia history0.600.051Previous CABG1.660.054Diabetes history1.630.094

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Accession: 034640027

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DOI: 10.1016/j.clpt.2003.11.208

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