The effects of carvedilol and nebivolol on oxidative stress status in patients with non-ischaemic heart failure

Abstract

Background: Carvedilol and nebivolol have favourable properties such as anti-oxidative effects in addition to other beta-blockers. However, which of these drugs is more effective on oxidative stress is unclear. Aim: To compare the effects carvedilol and nebivolol on oxidative stress status in non-ischaemic heart failure (HF) patients. Methods: We included 56 symptomatic non-ischaemic HF patients with ejection fraction ≤ 40%. The patients were randomised to carvedilol (n = 29, 18 male) or nebivolol (n = 27, 18 male) groups. They were evaluated clinically and echocardiographically after target dose. We evaluated parameters associated with oxidative stress, such as alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), uric acid, total antioxidant capacity (TAC), total oxidative status (TOS), and oxidative stress index (OSI). Results: TAC, TOS, GGT, and ALP levels and OSI were comparable in both groups. Uric acid levels were lower in the carvedilol group compared with the nebivolol group (5.8 ± 1.6 vs. 7.0 ± 1.7 mg/dL, p = 0.01). In correlation analysis, uric acid (p < 0.001, r = 0.50) and TOS level (p < 0.001, r = 0.73) were positively correlated with OSI.