PURPOSE:To assess the clinical effects and safety profile of initial monotherapy with either bisoprolol or enalapril in elderly patients with heart failure (HF). METHODS:In CIBIS III, 1010 patients with mild to moderate HF and age>or=65 years were randomized to monotherapy with either bisoprolol or enalapril for 6 months. RESULTS:Bisoprolol had a similar effect as enalapril on the combined end-point of all-cause mortality or hospitalization (HR 1.02; p=0.90), as well as on each of the individual end-points. A trend towards fewer sudden deaths was observed with bisoprolol (NS). On the other hand, more cases of worsening HF requiring hospitalization or occurring while in hospital were observed in the bisoprolol group (HR 1.67; p=0.03). The two groups were similar with regard to treatment cessations and early introduction of the second drug. CONCLUSIONS:Bisoprolol and enalapril had a similar effect on the combined end-point of mortality or hospitalization during 6 months monotherapy. However, more worsening HF events were observed in the bisoprolol group.

译文

目的:评估比索洛尔或依那普利初次单药治疗老年心力衰竭(HF)的临床效果和安全性。
方法:在CIBIS III中,将1010例轻度至中度HF且年龄≥65岁的患者随机分为比索洛尔或依那普利单药治疗6个月。
结果:比索洛尔在全因死亡率或住院综合终点(HR 1.02; p = 0.90)以及各个终点上具有与依那普利相似的作用。比索洛尔(NS)观察到突然死亡的趋势有所减少。另一方面,在比索洛尔组中观察到更多需要住院治疗或在住院期间发生的心衰恶化病例(HR 1.67; p = 0.03)。两组在停止治疗和早期引入第二种药物方面相似。
结论:比索洛尔和依那普利对6个月单药治疗死亡率或住院综合终点的影响相似。但是,在比索洛尔组中观察到更严重的HF事件。

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