Effects of β-Blocker Therapy on High Sensitivity C-Reactive Protein, Oxidative Stress, and Cardiac Function in Patients With Congestive Heart Failure

Background: It is uncertain whether β-blocker therapy affects serum C-reactive protein (CRP) level in patients with congestive heart failure (CHF). We attempted to determine if β-blocker therapy decreases serum CRP production and to correlate the production with biomarkers and cardiac function in such patients. Methods and Results: Fifty-two patients with mild to moderate CHF with a left ventricular ejection fraction (EF) <40% were enrolled. They were randomly assigned to metoprolol or carvedilol treatment groups. The CRP concentration decreased significantly in patients with higher baseline CRP concentration, but not in those with lower baseline CRP concentrations. There was an inverse correlation between ΔCRP and ΔEF 16 weeks after the start of β-blocker therapy for patients with higher baseline CRP concentrations. In patients with higher baseline concentrations, CRP decreased in patients who received carvedilol, but not in those who received metoprolol. Plasma lipid peroxide (LPO) concentration significantly decreased, and there was an inverse correlation between ΔCRP and ΔLPO 16 weeks after the start of therapy. Conclusions: Administration of β-blockers is associated with attenuation of inflammatory marker in certain patients with CHF. The antioxidant effects of β-blockers, especially carvedilol, may play a role in mediating the phenomenon.