Nebivolol

Sule, Sachin; Frishman, William H.

doi:10.1097/01.crd.0000223651.03023.8e

Cited by 39 publications

(6 citation statements)

References 63 publications

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“…25 Nebivolol has a higher degree of beta-1 selectivity than any other beta-blocker, explaining the minimal effects noted on the airways of asthmatic patients or insulin sensitivity in those with diabetes. 26 Metabolism and elimination of nebivolol is almost entirely through hepatic cytochrome P450 enzymes, although the minimal amount of drug excreted unchanged in the urine can be important in patients with severe renal impairment. 26 This may explain the higher rate of bradycardia seen in those with low eGFR in our study.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of nebivolol in elderly heart failure patients with impaired renal function: insights from the SENIORS trial

Cohen‐Solal

Kotecha

Veldhuisen

et al. 2009

European J of Heart Fail

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AimTo determine the safety and efficacy of nebivolol in elderly heart failure (HF) patients with renal dysfunction.Methods and resultsSENIORS recruited patients aged 70 years or older with symptomatic HF, irrespective of ejection fraction, and randomized them to nebivolol or placebo. Patients (n = 2112) were divided by tertile of estimated glomerular filtration rate (eGFR). Mean age of patients was 76.1 years, 35% of patients had an ejection fraction of >35%, and 37% were women resulting in a unique cohort, far more representative of clinical practice than previous trials. eGFR was strongly associated with outcomes and nebivolol was similarly efficacious across eGFR tertiles. The primary outcome rate (all-cause mortality or cardiovascular hospital admission) and adjusted hazard ratio for nebivolol use in those with low eGFR was 40% and 0.84 (95% CI 0.67–1.07), 31% and 0.79 (0.60–1.04) in the middle tertile, and 29% and 0.86 (0.65–1.14) in the highest eGFR tertile. There was no interaction noted between renal function and the treatment effect (P = 0.442). Nebivolol use in patients with moderate renal impairment (eGFR <60) was not associated with major safety concerns, apart from higher rates of drug-discontinuation due to bradycardia.ConclusionNebivolol is safe and has a similar effect in elderly HF patients with mild or moderate renal impairment.

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Section: Discussionmentioning

confidence: 99%

“…26 Metabolism and elimination of nebivolol is almost entirely through hepatic cytochrome P450 enzymes, although the minimal amount of drug excreted unchanged in the urine can be important in patients with severe renal impairment. 26 This may explain the higher rate of bradycardia seen in those with low eGFR in our study.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of nebivolol in elderly heart failure patients with impaired renal function: insights from the SENIORS trial

Cohen‐Solal

Kotecha

Veldhuisen

et al. 2009

European J of Heart Fail

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“…(7) Use of nebivolol: nebivolol is a β 1-adrenergic receptor antagonist, a third-generation beta-adrenergic blocker, with vasodilator and antioxidant properties [188, 189]. It has been hypothesized that nebivolol may protect the kidney against CIN through its antioxidant and NO-mediated vasodilator action.…”

Section: Contrast-induced Nephropathymentioning

confidence: 99%

Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention

Andreucci

Solomon

Tasanarong

2014

BioMed Research International

218

226

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Radiocontrast media (RCM) are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN). We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given.

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“…Nebivolol is a β 1 receptor antagonist which has vasodilatory and antioxidant effect [116, 117]. After contrast media administration, the pretreated rats with nebivolol had less oxidative stress marker and histological abnormalities compared to those without nebivolol pretreatment [118].…”

Section: Pharmacological Strategies To Prevent Ci-akimentioning

confidence: 99%

Pharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

Pattharanitima

Tasanarong

2014

BioMed Research International

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Contrast-induced acute kidney injury (CI-AKI) is the most common iatrogenic cause of acute kidney injury after intravenous contrast media administration. In general, the incidence of CI-AKI is low in patients with normal renal function. However, the rate is remarkably elevated in patients with preexisting chronic kidney disease, diabetes mellitus, old age, high volume of contrast agent, congestive heart failure, hypotension, anemia, use of nephrotoxic drug, and volume depletion. Consequently, CI-AKI particularly in high risk patients contributes to extended hospitalizations and increases long-term morbidity and mortality. The pathogenesis of CI-AKI involves at least three mechanisms; contrast agents induce renal vasoconstriction, increase of oxygen free radicals through oxidative stress, and direct tubular toxicity. Several strategies to prevent CI-AKI have been evaluated in experimental studies and clinical trials. At present, intravascular volume expansion with either isotonic saline or sodium bicarbonate solutions has provided more consistent positive results and was recommended in the prevention of CI-AKI. However, the proportion of patients with risk still develops CI-AKI. This review critically evaluated the current evidence for pharmacological strategies to prevent CI-AKI in patients with a risk of developing CI-AKI.

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Nebivolol

Cited by 39 publications

References 63 publications

Efficacy and safety of nebivolol in elderly heart failure patients with impaired renal function: insights from the SENIORS trial

Efficacy and safety of nebivolol in elderly heart failure patients with impaired renal function: insights from the SENIORS trial

Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention

Pharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

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