Impact of the beta-1 adrenergic receptor polymorphism on tolerability and efficacy of bisoprolol therapy in Korean heart failure patients: association between beta adrenergic receptor polymorphism and bisoprolol therapy in heart failure (ABBA) study
- Authors
- Lee, Hae-Young; Chung, Wook-Jin; Jeon, Hui-Kyung; Seo, Hong-Seog; Choi, Dong-Ju; Jeon, Eun-Seok; Kim, Jae-Joong; Shin, Joon Han; Kang, Seok-Min; Lim, Sung Cil; Baek, Sang-Hong
- Issue Date
- 3월-2016
- Publisher
- KOREAN ASSOC INTERNAL MEDICINE
- Keywords
- Heart failure; Beta-blocker; Polymorphism; Receptors; adrenergic; beta
- Citation
- KOREAN JOURNAL OF INTERNAL MEDICINE, v.31, no.2, pp.277 - 287
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN JOURNAL OF INTERNAL MEDICINE
- Volume
- 31
- Number
- 2
- Start Page
- 277
- End Page
- 287
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/89387
- DOI
- 10.3904/kjim.2015.043
- ISSN
- 1226-3303
- Abstract
- Background/Aims: We evaluated the association between coding region variants of adrenergic receptor genes and therapeutic effect in patients with congestive heart failure (CHF). Methods: One hundred patients with stable CHF (left ventricular ejection fraction [LVEF] < 45%) were enrolled. Enrolled patients started 1.25 mg bisoprolol treatment once daily, then up-titrated to the maximally tolerable dose, at which they were treated for 1 year. Results: Genotypic analysis was carried out, but the results were blinded to the investigators throughout the study period. At position 389 of the beta-1 adrenergic receptor gene (ADRB1), the observed minor Gly allele frequency (Gly389Arg + Gly389Gly) was 0.21, and no deviation from Hardy-Weinberg equilibrium was observed in the genotypic distribution of Arg389Gly (p = 0.75). Heart rate was reduced from 80.8 +/- 14.3 to 70.0 +/- 15.0 beats per minute (p < 0.0001). There was no significant difference in final heart rate across genotypes. However, the Arg389Arg genotype group required significantly more bisoprolol compared to the Gly389X (Gly389Arg + Gly389Gly) group (5.26 +/- 2.62 mg vs. 3.96 +/- 2.05 mg, p = 0.022). There were no significant differences in LVEF changes or remodeling between two groups. Also, changes in exercise capacity and brain natriuretic peptide level were not significant. However, interestingly, there was a two-fold higher rate of readmission (21.2% vs. 10.0%, p = 0.162) and one CHF-related death in the Arg389Arg group. Conclusions: The ADRB1 Gly389X genotype showed greater response to bisoprolol than the Arg389Arg genotype, suggesting the potential of individually tailoring beta-blocker therapy according to genotype.
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