The work was aimed at studiing the relationship between the efficiency of bisoprolol and the polymorphism of β1- and β2-adrenergic receptors (β-AR) genes in patients with heart failure (HF).
The two-year study included 251 patients with heart failure (with myocardial infarction on the background of coronary heart disease). During hospitalization, a standardized examination and prescription of therapy was carried out, including β-adrenergic blocking agent (β1-AB) - bisoprolol. Afterward, 61 (24.4%) patients stopped taking β1-AB (bisoprolol) as a result of intolerance or violation of compliance; 190 patients took bisoprolol for 2 years. The frequency of rehospitalization (RH) due to decompensation of HF (or intravenous injection of loop diuretics), mortality, and the development of a composite endpoint (CE) for 2 years was taken into account. The control group consisted of 55 healthy individuals. Genotyping was performed using 3 polymorphisms (Gly389Arg of the β1-АR gene, Ser49Gly of the β1-АR gene, Gln27Glu of the β2-АR gene) using the polymerase chain reaction. Genetic and epidemiological analysis was carried out using the SNPStats program.
The use of bisoprolol with HF reduces the risk of re-hospitalization (odds ratio (OR) = 0.519 (0.278–0.967); p = 0.037) and CE (OR = 0.494 (0.271–0.900); p = 0.030) for 2 years of treatment. Treatment of patients with bisoprolol in a dose of> 5 mg leads to a decrease in the risk of CE with G/A polymorphism Ser49Gly (c.145A> G) of the β1-AR gene (OR = 0.18 (0.04-0.84), with p = 0.014). The use of this drug at this dose also leads to a decrease in the frequency of RH and CE with the homozygous genotype C (C/C) of the Gln27Glu polymorphism (c.79C> G) of the β2-AR gene (OR = 0.09 (0.02–0.46), at p = 0.018 and OR = 0.14 (0.04–0.58), at p = 0.006, respectively).
Key words: heart failure, polymorphism, gene, β1-adrenergic receptors, β2-adrenergic receptors, bisoprolol, efficiency.