Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS‐ELD trial
Identifieur interne : 000C71 ( Istex/Corpus ); précédent : 000C70; suivant : 000C72Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS‐ELD trial
Auteurs : Hans-Dirk Düngen ; Svetlana Apostolovi ; Simone Inkrot ; Elvis Tahirovi ; Agnieszka Töpper ; Felix Mehrhof ; Christiane Prettin ; Biljana Putnikovi ; Aleksandar N. Neškovi ; Mirjana Krotin ; Dejan Saka ; Mitja Lainš Ak ; Frank Edelmann ; Rolf Wachter ; Thomas Rau ; Thomas Eschenhagen ; Wolfram Doehner ; Stefan D. Anker ; Finn Waagstein ; Christoph Herrmann-Lingen ; Goetz Gelbrich ; Rainer DietzSource :
- European Journal of Heart Failure [ 1388-9842 ] ; 2011-06.
Abstract
Various beta‐blockers with distinct pharmacological profiles are approved in heart failure, yet they remain underused and underdosed. Although potentially of major public health importance, whether one agent is superior in terms of tolerability and optimal dosing has not been investigated. The aim of this study was therefore to compare the tolerability and clinical effects of two proven beta‐blockers in elderly patients with heart failure.
Url:
DOI: 10.1093/eurjhf/hfr020
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ISTEX:47222E9C93CF33B0BA8512D96142A5730B23B309Le document en format XML
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Neškovi</name><affiliation><mods:affiliation>Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</mods:affiliation></affiliation></author><author><name sortKey="Krotin, Mirjana" sort="Krotin, Mirjana" uniqKey="Krotin M" first="Mirjana" last="Krotin">Mirjana Krotin</name><affiliation><mods:affiliation>Department of Cardiology, University Clinical Hospital ‘Bežanijska Kosa’, Belgrade, Serbia</mods:affiliation></affiliation></author><author><name sortKey="Saka, Dejan" sort="Saka, Dejan" uniqKey="Saka D" first="Dejan" last="Saka">Dejan Saka</name><affiliation><mods:affiliation>Institute for Cardiovascular Diseases, Sremska Kamenica, Serbia</mods:affiliation></affiliation></author><author><name sortKey="Lains Ak, Mitja" sort="Lains Ak, Mitja" uniqKey="Lains Ak M" first="Mitja" last="Lainš Ak">Mitja Lainš Ak</name><affiliation><mods:affiliation>Department of Cardiology, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia</mods:affiliation></affiliation></author><author><name sortKey="Edelmann, Frank" sort="Edelmann, Frank" uniqKey="Edelmann F" first="Frank" last="Edelmann">Frank Edelmann</name><affiliation><mods:affiliation>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wachter, Rolf" sort="Wachter, Rolf" uniqKey="Wachter R" first="Rolf" last="Wachter">Rolf Wachter</name><affiliation><mods:affiliation>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Rau, Thomas" sort="Rau, Thomas" uniqKey="Rau T" first="Thomas" last="Rau">Thomas Rau</name><affiliation><mods:affiliation>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Eschenhagen, Thomas" sort="Eschenhagen, Thomas" uniqKey="Eschenhagen T" first="Thomas" last="Eschenhagen">Thomas Eschenhagen</name><affiliation><mods:affiliation>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Doehner, Wolfram" sort="Doehner, Wolfram" uniqKey="Doehner W" first="Wolfram" last="Doehner">Wolfram Doehner</name><affiliation><mods:affiliation>Center for Stroke Research, Charité‐Universitätsmedizin, Campus Virchow‐Klinkum, Berlin, Germany</mods:affiliation></affiliation></author><author><name sortKey="Anker, Stefan D" sort="Anker, Stefan D" uniqKey="Anker S" first="Stefan D." last="Anker">Stefan D. Anker</name><affiliation><mods:affiliation>Department of Cardiology, Applied Cachexia Research, Charité‐Universitätsmedizin, Berlin, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Waagstein, Finn" sort="Waagstein, Finn" uniqKey="Waagstein F" first="Finn" last="Waagstein">Finn Waagstein</name><affiliation><mods:affiliation>Wallenberg Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden</mods:affiliation></affiliation></author><author><name sortKey="Herrmann Ingen, Christoph" sort="Herrmann Ingen, Christoph" uniqKey="Herrmann Ingen C" first="Christoph" last="Herrmann-Lingen">Christoph Herrmann-Lingen</name><affiliation><mods:affiliation>Department of Psychosomatic Medicine and Psychotherapy, Göttingen University Medical Center, Göttingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gelbrich, Goetz" sort="Gelbrich, Goetz" uniqKey="Gelbrich G" first="Goetz" last="Gelbrich">Goetz Gelbrich</name><affiliation><mods:affiliation>Clinical Trial Center, University of Leipzig, Leipzig, Germany</mods:affiliation></affiliation></author><author><name sortKey="Dietz, Rainer" sort="Dietz, Rainer" uniqKey="Dietz R" first="Rainer" last="Dietz">Rainer Dietz</name><affiliation><mods:affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:47222E9C93CF33B0BA8512D96142A5730B23B309</idno><date when="2011" year="2011">2011</date><idno type="doi">10.1093/eurjhf/hfr020</idno><idno type="url">https://api.istex.fr/document/47222E9C93CF33B0BA8512D96142A5730B23B309/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000C71</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS‐ELD trial</title><author><name sortKey="Dungen, Hans Irk" sort="Dungen, Hans Irk" uniqKey="Dungen H" first="Hans-Dirk" last="Düngen">Hans-Dirk Düngen</name><affiliation><mods:affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</mods:affiliation></affiliation></author><author><name sortKey="Apostolovi, Svetlana" sort="Apostolovi, Svetlana" uniqKey="Apostolovi S" first="Svetlana" last="Apostolovi">Svetlana Apostolovi</name><affiliation><mods:affiliation>Department of Cardiology, Niš, Clinical Center Niš, Serbia</mods:affiliation></affiliation></author><author><name sortKey="Inkrot, Simone" sort="Inkrot, Simone" uniqKey="Inkrot S" first="Simone" last="Inkrot">Simone Inkrot</name><affiliation><mods:affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</mods:affiliation></affiliation></author><author><name sortKey="Tahirovi, Elvis" sort="Tahirovi, Elvis" uniqKey="Tahirovi E" first="Elvis" last="Tahirovi">Elvis Tahirovi</name><affiliation><mods:affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</mods:affiliation></affiliation></author><author><name sortKey="Topper, Agnieszka" sort="Topper, Agnieszka" uniqKey="Topper A" first="Agnieszka" last="Töpper">Agnieszka Töpper</name><affiliation><mods:affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</mods:affiliation></affiliation></author><author><name sortKey="Mehrhof, Felix" sort="Mehrhof, Felix" uniqKey="Mehrhof F" first="Felix" last="Mehrhof">Felix Mehrhof</name><affiliation><mods:affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</mods:affiliation></affiliation></author><author><name sortKey="Prettin, Christiane" sort="Prettin, Christiane" uniqKey="Prettin C" first="Christiane" last="Prettin">Christiane Prettin</name><affiliation><mods:affiliation>Clinical Trial Center, University of Leipzig, Leipzig, Germany</mods:affiliation></affiliation></author><author><name sortKey="Putnikovi, Biljana" sort="Putnikovi, Biljana" uniqKey="Putnikovi B" first="Biljana" last="Putnikovi">Biljana Putnikovi</name><affiliation><mods:affiliation>Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</mods:affiliation></affiliation></author><author><name sortKey="Neskovi, Aleksandar N" sort="Neskovi, Aleksandar N" uniqKey="Neskovi A" first="Aleksandar N." last="Neškovi">Aleksandar N. Neškovi</name><affiliation><mods:affiliation>Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</mods:affiliation></affiliation></author><author><name sortKey="Krotin, Mirjana" sort="Krotin, Mirjana" uniqKey="Krotin M" first="Mirjana" last="Krotin">Mirjana Krotin</name><affiliation><mods:affiliation>Department of Cardiology, University Clinical Hospital ‘Bežanijska Kosa’, Belgrade, Serbia</mods:affiliation></affiliation></author><author><name sortKey="Saka, Dejan" sort="Saka, Dejan" uniqKey="Saka D" first="Dejan" last="Saka">Dejan Saka</name><affiliation><mods:affiliation>Institute for Cardiovascular Diseases, Sremska Kamenica, Serbia</mods:affiliation></affiliation></author><author><name sortKey="Lains Ak, Mitja" sort="Lains Ak, Mitja" uniqKey="Lains Ak M" first="Mitja" last="Lainš Ak">Mitja Lainš Ak</name><affiliation><mods:affiliation>Department of Cardiology, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia</mods:affiliation></affiliation></author><author><name sortKey="Edelmann, Frank" sort="Edelmann, Frank" uniqKey="Edelmann F" first="Frank" last="Edelmann">Frank Edelmann</name><affiliation><mods:affiliation>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wachter, Rolf" sort="Wachter, Rolf" uniqKey="Wachter R" first="Rolf" last="Wachter">Rolf Wachter</name><affiliation><mods:affiliation>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Rau, Thomas" sort="Rau, Thomas" uniqKey="Rau T" first="Thomas" last="Rau">Thomas Rau</name><affiliation><mods:affiliation>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Eschenhagen, Thomas" sort="Eschenhagen, Thomas" uniqKey="Eschenhagen T" first="Thomas" last="Eschenhagen">Thomas Eschenhagen</name><affiliation><mods:affiliation>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Doehner, Wolfram" sort="Doehner, Wolfram" uniqKey="Doehner W" first="Wolfram" last="Doehner">Wolfram Doehner</name><affiliation><mods:affiliation>Center for Stroke Research, Charité‐Universitätsmedizin, Campus Virchow‐Klinkum, Berlin, Germany</mods:affiliation></affiliation></author><author><name sortKey="Anker, Stefan D" sort="Anker, Stefan D" uniqKey="Anker S" first="Stefan D." last="Anker">Stefan D. Anker</name><affiliation><mods:affiliation>Department of Cardiology, Applied Cachexia Research, Charité‐Universitätsmedizin, Berlin, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Waagstein, Finn" sort="Waagstein, Finn" uniqKey="Waagstein F" first="Finn" last="Waagstein">Finn Waagstein</name><affiliation><mods:affiliation>Wallenberg Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden</mods:affiliation></affiliation></author><author><name sortKey="Herrmann Ingen, Christoph" sort="Herrmann Ingen, Christoph" uniqKey="Herrmann Ingen C" first="Christoph" last="Herrmann-Lingen">Christoph Herrmann-Lingen</name><affiliation><mods:affiliation>Department of Psychosomatic Medicine and Psychotherapy, Göttingen University Medical Center, Göttingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gelbrich, Goetz" sort="Gelbrich, Goetz" uniqKey="Gelbrich G" first="Goetz" last="Gelbrich">Goetz Gelbrich</name><affiliation><mods:affiliation>Clinical Trial Center, University of Leipzig, Leipzig, Germany</mods:affiliation></affiliation></author><author><name sortKey="Dietz, Rainer" sort="Dietz, Rainer" uniqKey="Dietz R" first="Rainer" last="Dietz">Rainer Dietz</name><affiliation><mods:affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">European Journal of Heart Failure</title><title level="j" type="abbrev">European Journal of Heart Failure</title><idno type="ISSN">1388-9842</idno><idno type="eISSN">1879-0844</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><date type="published" when="2011-06">2011-06</date><biblScope unit="volume">13</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="670">670</biblScope><biblScope unit="page" to="680">680</biblScope></imprint><idno type="ISSN">1388-9842</idno></series><idno type="istex">47222E9C93CF33B0BA8512D96142A5730B23B309</idno><idno type="DOI">10.1093/eurjhf/hfr020</idno><idno type="ArticleID">EJHFHFR020</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1388-9842</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Various beta‐blockers with distinct pharmacological profiles are approved in heart failure, yet they remain underused and underdosed. Although potentially of major public health importance, whether one agent is superior in terms of tolerability and optimal dosing has not been investigated. The aim of this study was therefore to compare the tolerability and clinical effects of two proven beta‐blockers in elderly patients with heart failure.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Hans‐Dirk Düngen</name><affiliations><json:string>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</json:string></affiliations></json:item><json:item><name>Svetlana Apostolović</name><affiliations><json:string>Department of Cardiology, Niš, Clinical Center Niš, Serbia</json:string></affiliations></json:item><json:item><name>Simone Inkrot</name><affiliations><json:string>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</json:string></affiliations></json:item><json:item><name>Elvis Tahirović</name><affiliations><json:string>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</json:string></affiliations></json:item><json:item><name>Agnieszka Töpper</name><affiliations><json:string>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</json:string></affiliations></json:item><json:item><name>Felix Mehrhof</name><affiliations><json:string>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</json:string></affiliations></json:item><json:item><name>Christiane Prettin</name><affiliations><json:string>Clinical Trial Center, University of Leipzig, Leipzig, Germany</json:string></affiliations></json:item><json:item><name>Biljana Putniković</name><affiliations><json:string>Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</json:string></affiliations></json:item><json:item><name>Aleksandar N. Nešković</name><affiliations><json:string>Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</json:string></affiliations></json:item><json:item><name>Mirjana Krotin</name><affiliations><json:string>Department of Cardiology, University Clinical Hospital ‘Bežanijska Kosa’, Belgrade, Serbia</json:string></affiliations></json:item><json:item><name>Dejan Sakač</name><affiliations><json:string>Institute for Cardiovascular Diseases, Sremska Kamenica, Serbia</json:string></affiliations></json:item><json:item><name>Mitja Lainščak</name><affiliations><json:string>Department of Cardiology, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia</json:string></affiliations></json:item><json:item><name>Frank Edelmann</name><affiliations><json:string>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</json:string></affiliations></json:item><json:item><name>Rolf Wachter</name><affiliations><json:string>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</json:string></affiliations></json:item><json:item><name>Thomas Rau</name><affiliations><json:string>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</json:string></affiliations></json:item><json:item><name>Thomas Eschenhagen</name><affiliations><json:string>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</json:string></affiliations></json:item><json:item><name>Wolfram Doehner</name><affiliations><json:string>Center for Stroke Research, Charité‐Universitätsmedizin, Campus Virchow‐Klinkum, Berlin, Germany</json:string></affiliations></json:item><json:item><name>Stefan D. Anker</name><affiliations><json:string>Department of Cardiology, Applied Cachexia Research, Charité‐Universitätsmedizin, Berlin, Germany</json:string><json:string>Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy</json:string></affiliations></json:item><json:item><name>Finn Waagstein</name><affiliations><json:string>Wallenberg Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden</json:string></affiliations></json:item><json:item><name>Christoph Herrmann‐Lingen</name><affiliations><json:string>Department of Psychosomatic Medicine and Psychotherapy, Göttingen University Medical Center, Göttingen, Germany</json:string></affiliations></json:item><json:item><name>Goetz Gelbrich</name><affiliations><json:string>Clinical Trial Center, University of Leipzig, Leipzig, Germany</json:string></affiliations></json:item><json:item><name>Rainer Dietz</name><affiliations><json:string>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Heart failure</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Beta‐blocker</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Elderly</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Tolerability</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Target dose</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Lung function</value></json:item></subject><articleId><json:string>EJHFHFR020</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><qualityIndicators><score>6.768</score><pdfVersion>1.5</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>443</abstractCharCount><pdfWordCount>6105</pdfWordCount><pdfCharCount>41551</pdfCharCount><pdfPageCount>11</pdfPageCount><abstractWordCount>64</abstractWordCount></qualityIndicators><title>Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS‐ELD trial</title><corporate><json:item><name>on behalf of the CIBIS‐ELD investigators and Project Multicentre Trials in the Competence Network Heart Failure</name></json:item></corporate><genre><json:string>article</json:string></genre><host><volume>13</volume><publisherId><json:string>EJHF</json:string></publisherId><pages><total>11</total><last>680</last><first>670</first></pages><issn><json:string>1388-9842</json:string></issn><issue>6</issue><subject><json:item><value>Treatment</value></json:item></subject><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1879-0844</json:string></eissn><title>European Journal of Heart Failure</title><doi><json:string>10.1002/(ISSN)1879-0844</json:string></doi></host><publicationDate>2011</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1093/eurjhf/hfr020</json:string></doi><id>47222E9C93CF33B0BA8512D96142A5730B23B309</id><score>0.255201</score><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/47222E9C93CF33B0BA8512D96142A5730B23B309/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/47222E9C93CF33B0BA8512D96142A5730B23B309/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/47222E9C93CF33B0BA8512D96142A5730B23B309/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS‐ELD trial</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Ltd</publisher><availability status="free"><p>Open Access</p></availability><date>2013-12-14</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS‐ELD trial</title><author><orgName>on behalf of the CIBIS‐ELD investigators and Project Multicentre Trials in the Competence Network Heart Failure</orgName></author><author xml:id="author-1"><persName><forename type="first">Hans‐Dirk</forename><surname>Düngen</surname></persName><note type="correspondence"><p>Correspondence: Corresponding author. Tel: +49 30 450 676818, Fax: +4930 450 576913, Email:</p></note><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation></author><author xml:id="author-2"><persName><forename type="first">Svetlana</forename><surname>Apostolović</surname></persName><affiliation>Department of Cardiology, Niš, Clinical Center Niš, Serbia</affiliation></author><author xml:id="author-3"><persName><forename type="first">Simone</forename><surname>Inkrot</surname></persName><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation></author><author xml:id="author-4"><persName><forename type="first">Elvis</forename><surname>Tahirović</surname></persName><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation></author><author xml:id="author-5"><persName><forename type="first">Agnieszka</forename><surname>Töpper</surname></persName><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation></author><author xml:id="author-6"><persName><forename type="first">Felix</forename><surname>Mehrhof</surname></persName><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation></author><author xml:id="author-7"><persName><forename type="first">Christiane</forename><surname>Prettin</surname></persName><affiliation>Clinical Trial Center, University of Leipzig, Leipzig, Germany</affiliation></author><author xml:id="author-8"><persName><forename type="first">Biljana</forename><surname>Putniković</surname></persName><affiliation>Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</affiliation></author><author xml:id="author-9"><persName><forename type="first">Aleksandar N.</forename><surname>Nešković</surname></persName><affiliation>Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</affiliation></author><author xml:id="author-10"><persName><forename type="first">Mirjana</forename><surname>Krotin</surname></persName><affiliation>Department of Cardiology, University Clinical Hospital ‘Bežanijska Kosa’, Belgrade, Serbia</affiliation></author><author xml:id="author-11"><persName><forename type="first">Dejan</forename><surname>Sakač</surname></persName><affiliation>Institute for Cardiovascular Diseases, Sremska Kamenica, Serbia</affiliation></author><author xml:id="author-12"><persName><forename type="first">Mitja</forename><surname>Lainščak</surname></persName><affiliation>Department of Cardiology, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia</affiliation></author><author xml:id="author-13"><persName><forename type="first">Frank</forename><surname>Edelmann</surname></persName><affiliation>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</affiliation></author><author xml:id="author-14"><persName><forename type="first">Rolf</forename><surname>Wachter</surname></persName><affiliation>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</affiliation></author><author xml:id="author-15"><persName><forename type="first">Thomas</forename><surname>Rau</surname></persName><affiliation>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</affiliation></author><author xml:id="author-16"><persName><forename type="first">Thomas</forename><surname>Eschenhagen</surname></persName><affiliation>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</affiliation></author><author xml:id="author-17"><persName><forename type="first">Wolfram</forename><surname>Doehner</surname></persName><affiliation>Center for Stroke Research, Charité‐Universitätsmedizin, Campus Virchow‐Klinkum, Berlin, Germany</affiliation></author><author xml:id="author-18"><persName><forename type="first">Stefan D.</forename><surname>Anker</surname></persName><affiliation>Department of Cardiology, Applied Cachexia Research, Charité‐Universitätsmedizin, Berlin, Germany</affiliation><affiliation>Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy</affiliation></author><author xml:id="author-19"><persName><forename type="first">Finn</forename><surname>Waagstein</surname></persName><affiliation>Wallenberg Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden</affiliation></author><author xml:id="author-20"><persName><forename type="first">Christoph</forename><surname>Herrmann‐Lingen</surname></persName><affiliation>Department of Psychosomatic Medicine and Psychotherapy, Göttingen University Medical Center, Göttingen, Germany</affiliation></author><author xml:id="author-21"><persName><forename type="first">Goetz</forename><surname>Gelbrich</surname></persName><affiliation>Clinical Trial Center, University of Leipzig, Leipzig, Germany</affiliation></author><author xml:id="author-22"><persName><forename type="first">Rainer</forename><surname>Dietz</surname></persName><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation></author></analytic><monogr><title level="j">European Journal of Heart Failure</title><title level="j" type="abbrev">European Journal of Heart Failure</title><idno type="pISSN">1388-9842</idno><idno type="eISSN">1879-0844</idno><idno type="DOI">10.1002/(ISSN)1879-0844</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><date type="published" when="2011-06"></date><biblScope unit="volume">13</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="670">670</biblScope><biblScope unit="page" to="680">680</biblScope></imprint></monogr><idno type="istex">47222E9C93CF33B0BA8512D96142A5730B23B309</idno><idno type="DOI">10.1093/eurjhf/hfr020</idno><idno type="ArticleID">EJHFHFR020</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2013-12-14</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Various beta‐blockers with distinct pharmacological profiles are approved in heart failure, yet they remain underused and underdosed. Although potentially of major public health importance, whether one agent is superior in terms of tolerability and optimal dosing has not been investigated. The aim of this study was therefore to compare the tolerability and clinical effects of two proven beta‐blockers in elderly patients with heart failure.</p></abstract><abstract><p>We performed a double‐blind superiority trial of bisoprolol vs. carvedilol in 883 elderly heart failure patients with reduced or preserved left ventricular ejection fraction in 41 European centres. The primary endpoint was tolerability, defined as reaching and maintaining guideline‐recommended target doses after 12 weeks treatment. Adverse events and clinical parameters of patient status were secondary endpoints. None of the beta‐blockers was superior with regards to tolerability: 24% [95% confidence interval (CI) 20–28] of patients in the bisoprolol arm and 25% (95% CI 21–29) of patients in the carvedilol arm achieved the primary endpoint (P= 0.64). The use of bisoprolol resulted in greater reduction of heart rate (adjusted mean difference 2.1 b.p.m., 95% CI 0.5–3.6, P= 0.008) and more, dose‐limiting, bradycardic adverse events (16 vs. 11%; P= 0.02). The use of carvedilol led to a reduction of forced expiratory volume (adjusted mean difference 50 mL, 95% CI 4–95, P= 0.03) and more, non‐dose‐limiting, pulmonary adverse events (10 vs. 4%; P < 0.001).</p></abstract><abstract><p>Overall tolerability to target doses was comparable. The pattern of intolerance, however, was different: bradycardia occurred more often in the bisoprolol group, whereas pulmonary adverse events occurred more often in the carvedilol group. This study is registered with controlled‐trials.com, number ISRCTN34827306.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>Heart failure</term></item><item><term>Beta‐blocker</term></item><item><term>Elderly</term></item><item><term>Tolerability</term></item><item><term>Target dose</term></item><item><term>Lung function</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article-category</head><item><term>Treatment</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2011-01-07">Received</change><change when="2011-01-22">Registration</change><change when="2013-12-14">Created</change><change when="2011-06">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/47222E9C93CF33B0BA8512D96142A5730B23B309/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en" xml:id="EJHFHFR020"><header><publicationMeta level="product"><doi origin="wiley">10.1002/(ISSN)1879-0844</doi><issn type="print">1388-9842</issn><issn type="electronic">1879-0844</issn><idGroup><id type="product" value="EJHF"></id></idGroup><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="4"></count><count type="referenceTotal" number="27"></count></countGroup><titleGroup><title type="main" sort="EUROPEAN JOURNAL OF HEART FAILURE">European Journal of Heart Failure</title><title type="short">European Journal of Heart Failure</title></titleGroup><attributeValueGroup><attributeValue element="legalStatement" attribute="type" value="creativeCommonsBy-nc"></attributeValue></attributeValueGroup></publicationMeta><publicationMeta level="part" position="60"><doi origin="wiley">10.1002/ejhf.2011.13.issue-6</doi><copyright ownership="publisher">© 2011 European Society of Cardiology</copyright><numberingGroup><numbering type="journalVolume" number="13">13</numbering><numbering type="journalIssue">6</numbering></numberingGroup><coverDate startDate="2011-06">June 2011</coverDate></publicationMeta><publicationMeta level="unit" position="150" type="article" status="forIssue" accessType="open"><doi origin="wiley">10.1093/eurjhf/hfr020</doi><idGroup><id type="unit" value="EJHFHFR020"></id></idGroup><countGroup><count type="pageTotal" number="11"></count></countGroup><titleGroup><title type="articleCategory">Treatment</title><title type="tocHeading1">Treatment</title></titleGroup><copyright ownership="thirdParty">Published on behalf of the European Society of Cardiology. All rights reserved. © 2011 the Authors</copyright><legalStatement type="creativeCommonsBy-nc"><p>This is an open access article under the terms of the <url href="http://creativecommons.org/licenses/by-nc/3.0/">Creative Commons Attribution‐NonCommercial</url> License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.</p></legalStatement><eventGroup><event type="manuscriptReceived" date="2011-01-07"></event><event type="manuscriptRevised" date="2011-01-21"></event><event type="manuscriptAccepted" date="2011-01-22"></event><event type="xmlCreated" agent="Aptara" date="2013-12-14"></event><event type="publishedOnlineFinalForm" date="2014-02-18"></event><event type="firstOnline" date="2014-02-18"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-16"></event></eventGroup><numberingGroup><numbering type="pageFirst">670</numbering><numbering type="pageLast">680</numbering></numberingGroup><correspondenceTo>Corresponding author. Tel: +49 30 450 676818, Fax: +4930 450 576913, Email: <email normalForm="hans-dirk.duengen@charite.de">hans‐dirk.duengen@charite.de</email></correspondenceTo><objectNameGroup><objectName elementName="appendix">Appendix</objectName></objectNameGroup><linkGroup><link type="toTypesetVersion" href="file://EJHF.EJHFHFR020.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="main">Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS‐ELD trial</title></titleGroup><creators><creator xml:id="ejhfhfr020-cr-0001" creatorRole="author" affiliationRef="#ejhfhfr020-aff-0001" corresponding="yes"><personName><givenNames>Hans‐Dirk</givenNames><familyName>Düngen</familyName></personName></creator><creator xml:id="ejhfhfr020-cr-0002" creatorRole="author" affiliationRef="#ejhfhfr020-aff-0002" corresponding="no"><personName><givenNames>Svetlana</givenNames><familyName>Apostolović</familyName></personName></creator><creator 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corresponding="no"><personName><givenNames>Thomas</givenNames><familyName>Eschenhagen</familyName></personName></creator><creator xml:id="ejhfhfr020-cr-0017" creatorRole="author" affiliationRef="#ejhfhfr020-aff-0010" corresponding="no"><personName><givenNames>Wolfram</givenNames><familyName>Doehner</familyName></personName></creator><creator xml:id="ejhfhfr020-cr-0018" creatorRole="author" affiliationRef="#ejhfhfr020-aff-0011 #ejhfhfr020-aff-0012" corresponding="no"><personName><givenNames>Stefan D.</givenNames><familyName>Anker</familyName></personName></creator><creator xml:id="ejhfhfr020-cr-0019" creatorRole="author" affiliationRef="#ejhfhfr020-aff-0013" corresponding="no"><personName><givenNames>Finn</givenNames><familyName>Waagstein</familyName></personName></creator><creator xml:id="ejhfhfr020-cr-0020" creatorRole="author" affiliationRef="#ejhfhfr020-aff-0014" corresponding="no"><personName><givenNames>Christoph</givenNames><familyName>Herrmann‐Lingen</familyName></personName></creator><creator xml:id="ejhfhfr020-cr-0021" creatorRole="author" affiliationRef="#ejhfhfr020-aff-0003" corresponding="no"><personName><givenNames>Goetz</givenNames><familyName>Gelbrich</familyName></personName></creator><creator xml:id="ejhfhfr020-cr-0022" creatorRole="author" affiliationRef="#ejhfhfr020-aff-0001" corresponding="no"><personName><givenNames>Rainer</givenNames><familyName>Dietz</familyName></personName></creator><creator xml:id="ejhfhfr020-cr-0023" creatorRole="author" corresponding="no"><groupName>on behalf of the CIBIS‐ELD investigators and Project Multicentre Trials in the Competence Network Heart Failure</groupName></creator></creators><affiliationGroup><affiliation xml:id="ejhfhfr020-aff-0001" type="organization" countryCode="DE"><orgDiv>Department of Internal Medicine—Cardiology</orgDiv><orgName>Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1</orgName><address><postCode>13353</postCode><city>Berlin</city><country>Germany</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0002" type="organization" countryCode="RS"><orgDiv>Department of Cardiology, Niš</orgDiv><orgName>Clinical Center Niš</orgName><address><country>Serbia</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0003" type="organization" countryCode="DE"><orgDiv>Clinical Trial Center</orgDiv><orgName>University of Leipzig</orgName><address><city>Leipzig</city><country>Germany</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0004" type="organization" countryCode="RS"><orgDiv>Department of Cardiology, Clinical Hospital Center Zemun</orgDiv><orgName>Faculty of Medicine, University of Belgrade</orgName><address><city>Belgrade</city><country>Serbia</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0005" type="organization" countryCode="RS"><orgDiv>Department of Cardiology</orgDiv><orgName>University Clinical Hospital ‘Bežanijska Kosa’</orgName><address><city>Belgrade</city><country>Serbia</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0006" type="organization" countryCode="RS"><orgName>Institute for Cardiovascular Diseases</orgName><address><city>Sremska Kamenica</city><country>Serbia</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0007" type="organization" countryCode="SI"><orgDiv>Department of Cardiology</orgDiv><orgName>University Clinic of Respiratory and Allergic Diseases</orgName><address><city>Golnik</city><country>Slovenia</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0008" type="organization" countryCode="DE"><orgDiv>Department of Cardiology and Pneumology</orgDiv><orgName>Göttingen University Medical Center</orgName><address><city>Göttingen</city><country>Germany</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0009" type="organization" countryCode="DE"><orgDiv>Institute for Experimental and Clinical Pharmacology</orgDiv><orgName>University Medical Center Hamburg Eppendorf</orgName><address><city>Hamburg</city><country>Germany</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0010" type="organization" countryCode="DE"><orgDiv>Center for Stroke Research</orgDiv><orgName>Charité‐Universitätsmedizin, Campus Virchow‐Klinkum</orgName><address><city>Berlin</city><country>Germany</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0011" type="organization" countryCode="DE"><orgDiv>Department of Cardiology, Applied Cachexia Research</orgDiv><orgName>Charité‐Universitätsmedizin</orgName><address><city>Berlin</city><country>Germany</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0012" type="organization" countryCode="IT"><orgDiv>Centre for Clinical and Basic Research, IRCCS San Raffaele</orgDiv><address><city>Rome</city><country>Italy</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0013" type="organization" countryCode="SE"><orgDiv>Wallenberg Laboratory</orgDiv><orgName>Sahlgrenska University Hospital</orgName><address><city>Göteborg</city><country>Sweden</country></address></affiliation><affiliation xml:id="ejhfhfr020-aff-0014" type="organization" countryCode="DE"><orgDiv>Department of Psychosomatic Medicine and Psychotherapy</orgDiv><orgName>Göttingen University Medical Center</orgName><address><city>Göttingen</city><country>Germany</country></address></affiliation></affiliationGroup><keywordGroup type="author"><keyword xml:id="ejhfhfr020-kwd-0001">Heart failure</keyword><keyword xml:id="ejhfhfr020-kwd-0002">Beta‐blocker</keyword><keyword xml:id="ejhfhfr020-kwd-0003">Elderly</keyword><keyword xml:id="ejhfhfr020-kwd-0004">Tolerability</keyword><keyword xml:id="ejhfhfr020-kwd-0005">Target dose</keyword><keyword xml:id="ejhfhfr020-kwd-0006">Lung function</keyword></keywordGroup><abstractGroup><abstract type="main"><section xml:id="ejhfhfr020-sec-0001"><title type="main">Aims</title><p>Various beta‐blockers with distinct pharmacological profiles are approved in heart failure, yet they remain underused and underdosed. Although potentially of major public health importance, whether one agent is superior in terms of tolerability and optimal dosing has not been investigated. The aim of this study was therefore to compare the tolerability and clinical effects of two proven beta‐blockers in elderly patients with heart failure.</p></section><section xml:id="ejhfhfr020-sec-0002"><title type="main">Methods and results</title><p>We performed a double‐blind superiority trial of bisoprolol vs. carvedilol in 883 elderly heart failure patients with reduced or preserved left ventricular ejection fraction in 41 European centres. The primary endpoint was tolerability, defined as reaching and maintaining guideline‐recommended target doses after 12 weeks treatment. Adverse events and clinical parameters of patient status were secondary endpoints. None of the beta‐blockers was superior with regards to tolerability: 24% [95% confidence interval (CI) 20–28] of patients in the bisoprolol arm and 25% (95% CI 21–29) of patients in the carvedilol arm achieved the primary endpoint (<i>P</i>= 0.64). The use of bisoprolol resulted in greater reduction of heart rate (adjusted mean difference 2.1 b.p.m., 95% CI 0.5–3.6, <i>P</i>= 0.008) and more, dose‐limiting, bradycardic adverse events (16 vs. 11%; <i>P</i>= 0.02). The use of carvedilol led to a reduction of forced expiratory volume (adjusted mean difference 50 mL, 95% CI 4–95, <i>P</i>= 0.03) and more, non‐dose‐limiting, pulmonary adverse events (10 vs. 4%; <i>P</i> < 0.001).</p></section><section xml:id="ejhfhfr020-sec-0003"><title type="main">Conclusion</title><p>Overall tolerability to target doses was comparable. The pattern of intolerance, however, was different: bradycardia occurred more often in the bisoprolol group, whereas pulmonary adverse events occurred more often in the carvedilol group.</p><p>This study is registered with <url href="http://controlled-trials.com">controlled‐trials.com</url>, number ISRCTN34827306.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS‐ELD trial</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS‐ELD trial</title></titleInfo><name type="personal"><namePart type="given">Hans‐Dirk</namePart><namePart type="family">Düngen</namePart><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation><description>Correspondence: Corresponding author. Tel: +49 30 450 676818, Fax: +4930 450 576913, Email: </description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Svetlana</namePart><namePart type="family">Apostolović</namePart><affiliation>Department of Cardiology, Niš, Clinical Center Niš, Serbia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Simone</namePart><namePart type="family">Inkrot</namePart><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elvis</namePart><namePart type="family">Tahirović</namePart><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Agnieszka</namePart><namePart type="family">Töpper</namePart><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Felix</namePart><namePart type="family">Mehrhof</namePart><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Christiane</namePart><namePart type="family">Prettin</namePart><affiliation>Clinical Trial Center, University of Leipzig, Leipzig, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Biljana</namePart><namePart type="family">Putniković</namePart><affiliation>Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Aleksandar N.</namePart><namePart type="family">Nešković</namePart><affiliation>Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mirjana</namePart><namePart type="family">Krotin</namePart><affiliation>Department of Cardiology, University Clinical Hospital ‘Bežanijska Kosa’, Belgrade, Serbia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dejan</namePart><namePart type="family">Sakač</namePart><affiliation>Institute for Cardiovascular Diseases, Sremska Kamenica, Serbia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mitja</namePart><namePart type="family">Lainščak</namePart><affiliation>Department of Cardiology, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Frank</namePart><namePart type="family">Edelmann</namePart><affiliation>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rolf</namePart><namePart type="family">Wachter</namePart><affiliation>Department of Cardiology and Pneumology, Göttingen University Medical Center, Göttingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thomas</namePart><namePart type="family">Rau</namePart><affiliation>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thomas</namePart><namePart type="family">Eschenhagen</namePart><affiliation>Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg Eppendorf, Hamburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wolfram</namePart><namePart type="family">Doehner</namePart><affiliation>Center for Stroke Research, Charité‐Universitätsmedizin, Campus Virchow‐Klinkum, Berlin, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stefan D.</namePart><namePart type="family">Anker</namePart><affiliation>Department of Cardiology, Applied Cachexia Research, Charité‐Universitätsmedizin, Berlin, Germany</affiliation><affiliation>Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Finn</namePart><namePart type="family">Waagstein</namePart><affiliation>Wallenberg Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Christoph</namePart><namePart type="family">Herrmann‐Lingen</namePart><affiliation>Department of Psychosomatic Medicine and Psychotherapy, Göttingen University Medical Center, Göttingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Goetz</namePart><namePart type="family">Gelbrich</namePart><affiliation>Clinical Trial Center, University of Leipzig, Leipzig, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rainer</namePart><namePart type="family">Dietz</namePart><affiliation>Department of Internal Medicine—Cardiology, Charité‐Universitätsmedizin, Competence Network Heart Failure, Campus Virchow‐Klinkum, Augustenburger Platz 1, 13353, Berlin, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="corporate"><namePart>on behalf of the CIBIS‐ELD investigators and Project Multicentre Trials in the Competence Network Heart Failure</namePart></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2011-06</dateIssued><dateCreated encoding="w3cdtf">2013-12-14</dateCreated><dateCaptured encoding="w3cdtf">2011-01-07</dateCaptured><dateValid encoding="w3cdtf">2011-01-22</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Various beta‐blockers with distinct pharmacological profiles are approved in heart failure, yet they remain underused and underdosed. Although potentially of major public health importance, whether one agent is superior in terms of tolerability and optimal dosing has not been investigated. The aim of this study was therefore to compare the tolerability and clinical effects of two proven beta‐blockers in elderly patients with heart failure.</abstract><abstract>We performed a double‐blind superiority trial of bisoprolol vs. carvedilol in 883 elderly heart failure patients with reduced or preserved left ventricular ejection fraction in 41 European centres. The primary endpoint was tolerability, defined as reaching and maintaining guideline‐recommended target doses after 12 weeks treatment. Adverse events and clinical parameters of patient status were secondary endpoints. None of the beta‐blockers was superior with regards to tolerability: 24% [95% confidence interval (CI) 20–28] of patients in the bisoprolol arm and 25% (95% CI 21–29) of patients in the carvedilol arm achieved the primary endpoint (P= 0.64). The use of bisoprolol resulted in greater reduction of heart rate (adjusted mean difference 2.1 b.p.m., 95% CI 0.5–3.6, P= 0.008) and more, dose‐limiting, bradycardic adverse events (16 vs. 11%; P= 0.02). The use of carvedilol led to a reduction of forced expiratory volume (adjusted mean difference 50 mL, 95% CI 4–95, P= 0.03) and more, non‐dose‐limiting, pulmonary adverse events (10 vs. 4%; P < 0.001).</abstract><abstract>Overall tolerability to target doses was comparable. The pattern of intolerance, however, was different: bradycardia occurred more often in the bisoprolol group, whereas pulmonary adverse events occurred more often in the carvedilol group. This study is registered with controlled‐trials.com, number ISRCTN34827306.</abstract><subject><genre>keywords</genre><topic>Heart failure</topic><topic>Beta‐blocker</topic><topic>Elderly</topic><topic>Tolerability</topic><topic>Target dose</topic><topic>Lung function</topic></subject><relatedItem type="host"><titleInfo><title>European Journal of Heart Failure</title></titleInfo><titleInfo type="abbreviated"><title>European Journal of Heart Failure</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Treatment</topic></subject><identifier type="ISSN">1388-9842</identifier><identifier type="eISSN">1879-0844</identifier><identifier type="DOI">10.1002/(ISSN)1879-0844</identifier><identifier type="PublisherID">EJHF</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>13</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>670</start><end>680</end><total>11</total></extent></part></relatedItem><identifier type="istex">47222E9C93CF33B0BA8512D96142A5730B23B309</identifier><identifier type="DOI">10.1093/eurjhf/hfr020</identifier><identifier type="ArticleID">EJHFHFR020</identifier><accessCondition type="use and reproduction" contentType="creativeCommonsBy-nc">This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><enrichments><json:item><type>multicat</type><uri>https://api.istex.fr/document/47222E9C93CF33B0BA8512D96142A5730B23B309/enrichments/multicat</uri></json:item></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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