Efficacy and safety of carvedilol in combination with bronchodilators in patients with CHF of ischemic origin and COPD.

Abstract

Objective. To study the effectiveness of carvedilol, tiotropium bromide and indacaterol in complex therapy on clinical and functional parameters in patients with CHF of ischemic origin in combination with COPD. Material and methods. The study included 98 patients aged 45–75 years, suffering from CHF II–III FC with post-infarction cardiosclerosis, LV ejection fraction less than 45% and COPD of 2–3 degrees (GOLD). In addition to basic therapy all patients received carvedilol and were divided into 3 groups: tiotropium was administered in the 1st (36 people), indacaterol in the 2nd (32 people), and a combination of tiotropium and indacaterol in the 3rd (30 people). At baseline and after 6 months of follow-up, the clinical condition, exercise tolerance were assessed, the quality of life was assessed using the clinical state rating scale (SHOX) and MRC dyspnea scale, questionnaires of University of Minnesota (MLHFQ) and St. George’s Hospital (SGRQ). EchoCG, 24-hour blood pressure monitoring with simultaneous ECG recording, and spirometry test were performed. Results. The use of carvedilol in combination with tiotropium and indacaterol (both in mono and in combination) as part of complex therapy of CHF II–III FC of ischemic genesis with COPD is safe and effective: the clinical condition of patients improved, quality of life, frequency and duration of ischemia episodes decreased significantly, significantly increased LVEF, decreased pulmonary hypertension, improved condition of the bronchopulmonary system.