PMID- 12643888
OWN - NLM
STAT- MEDLINE
DCOM- 20030506
LR  - 20220330
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 24
IP  - 6
DP  - 2003 Mar
TI  - Bisoprolol dose-response relationship in patients with congestive heart failure: 
      a subgroup analysis in the cardiac insufficiency bisoprolol study(CIBIS II).
PG  - 552-9
AB  - AIMS: Whether all patients with congestive heart failure (CHF) need to reach the 
      target dose of beta-blocker to obtain a benefit in terms of survival remains 
      uncertain. METHODS AND RESULTS: We classified by tertile the 2647 patients 
      enrolled in CIBIS II according to the last tolerated dose: low dose (LD: 1.25, 
      2.5 or 3.75mg/day, n=434), moderate dose (MD: 5 or 7.5mg/day, n=328) and high 
      dose (HD: 10mg/day, n=565) of bisoprolol or placebo (LD=234, MD=278 and HD=808). 
      In both groups, patients tolerating only low doses were significantly older with 
      more severe New York Heart Association (NYHA) functional class and higher 
      frequency of co-morbidities. Treatment withdrawal was associated with a 
      significant increase of mortality in the bisoprolol group (relative hazard 
      (RH)=2.13, 95% confidence interval (CI)=1.43-3.17, p=0.0002). After adjustment, 
      all-cause mortality was significantly reduced in the bisoprolol group compared to 
      placebo regardless of the dose level considered: LD (RH=0.66, 95% CI=0.48-0.92), 
      MD (RH=0.33, 95% CI=0.21-0.51) or HD (RH=0.59, 95% CI=0.40-0.89). CONCLUSIONS: 
      Bisoprolol reduces mortality in CHF patients at all tolerated dose levels and its 
      withdrawal increases the risk of mortality. Efforts should be made to maintain 
      bisoprolol therapy based on the individual patient's tolerability.
FAU - Simon, T
AU  - Simon T
AD  - Department of Pharmacology, Saint Antoine University Hospital AP-HP, 27, Rue 
      Chaligny, 75012, Paris, France. tabassome.simon@chusa.jussieu.fr
FAU - Mary-Krause, M
AU  - Mary-Krause M
FAU - Funck-Brentano, C
AU  - Funck-Brentano C
FAU - Lechat, Ph
AU  - Lechat P
FAU - Jaillon, P
AU  - Jaillon P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Adrenergic beta-Antagonists)
RN  - Y41JS2NL6U (Bisoprolol)
SB  - IM
CIN - Eur Heart J. 2004 Feb;25(3):277. PMID: 14972430
MH  - Adrenergic beta-Antagonists/*administration & dosage
MH  - Bisoprolol/*administration & dosage
MH  - Death, Sudden, Cardiac
MH  - Dose-Response Relationship, Drug
MH  - Double-Blind Method
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Treatment Refusal
EDAT- 2003/03/20 04:00
MHDA- 2003/05/07 05:00
CRDT- 2003/03/20 04:00
PHST- 2003/03/20 04:00 [pubmed]
PHST- 2003/05/07 05:00 [medline]
PHST- 2003/03/20 04:00 [entrez]
AID - S0195668X02007431 [pii]
AID - 10.1016/s0195-668x(02)00743-1 [doi]
PST - ppublish
SO  - Eur Heart J. 2003 Mar;24(6):552-9. doi: 10.1016/s0195-668x(02)00743-1.