Bird’s eye view on the CIBIS studies – what they induced into heart failure treatment? Review article
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Abstract
Heart failure (HF) is a serious problem in the public health care system. Apart from angiotensin converting inhibitors (ACE-I), angiotensin receptor blockers, diuretics, digitalis, beta-adrenolytic agents (BB) are recommended method of treatment listed in the current guidelines of management of HF. The mechanism of action of BB is related with inhibition of sympathetic activity. According to the results of clinical trials BB were introduced to the pharmacotherapy of HF lately. One of those trials were CIBIS studies (Cardiac Insufficiency Bisoprolol Study: CIBIS, CIBIS II, CIBIS III) which were provided on 4300 cohort. Despite the observed difference in mortality between groups did not reach statistical significance (low bisoprolol maximum dose 5 mg), therapy with bisoprolol in CIBIS I reduced number of hospitalizations due to cardiac decompensation, improvement of at least one of New York Heart Association functional class. In CIBIS II (maximum bisoprolol dose 10 mg) bisoprolol showed a significant mortality benefit. CIBIS III Study revealed that initiating treatment with the selective β1 receptor blocker bisoprolol is as effective and well tolerated as beginning treatment with the ACE inhibitor enalapril. CIBIS studies influenced the shape of the current guidelines and also valued the importance of accurate dosing of BB in patients heart failure.
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