Abstract 2735: Effects of Carvedilol and Metoprolol on Plasma advanced Glycation End Products (AGE) and Advanced Oxidation Protein Products (AOPP) in Patients with Chronic Heart Failure
Background: Chronic heart failure (CHF) is characterized by abnormal neurohormonal activation. Advanced glycation end products (AGE) and advanced oxidation protein products (AOPP) maybe represent new exquisite markers of oxidative stress. Although beta blockers reduced mortality in patients who had CHF, the COMET trial had shown that there might be a difference in effects of carvedilol and metoprolol on clinical outcome in CHF patients. We sought to investigate the effects of carvedilol and metoprolol on left ventricular (LV) function and drug-induced changes in plasma AGE, AOPP, CRP and BNP in patients with CHF.
Methods and Results: On the standard therapy of CHF,Eighty-eight patients (NYHA II-III, LVEF 45±13%) were randomized to receive either carvedilol (n=45) or metoprolol (n=43). The plasma level of AGE was measured by competitive ELISA method, plasma AOPP by spectrophotometer, plasma BNP by RIA method and plasma CRP by velocity scatter turbidimetry, at baseline and after 3 months and 6 months of treatment respectively. Echocardiographic markers of LV function were examined too. The dosage of carvedilol group was 6.25~50mg per day, and 26 cases(60.5%)reached target dosage(25mg bid). The dosage of metoprolol group was 12.5~100mg per day, and 28 cases reached target dosage (50mg bid). Compared with the baseline data, plasma BNP levels decreased significantly in both groups since 3 months treatments and plasma CRP, AGE and AOPP decreased significantly in both groups after 6 months. After 6 months treatment, both plasma levels of AGE and AOPP in carvedilol group were lower significantly than in metoprolol group, but plasma BNP and CRP did not.
Conclusions: Either metoprolol or carvedilol reduced plasma levels of BNP and CRP and improved LV function. Carvedilol, but not metoprolol, was thus found to decrease the plasma levels of AGE and AOPP. This new effect of carvedilol might partly explain the beneficial effect of carvedilol for the treatment of CHF.