Miejsce bisoprololu we współczesnej kardiologii Artykuł przeglądowy
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Opublikowane:
paź 20, 2026
Słowa kluczowe:
bisoprolol, kardioselektywność, niewydolność serca z obniżoną frakcją wyrzutową, choroba wieńcowa, arytmie serca
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Abstrakt
Wiele wytycznych Europejskiego Towarzystwa Kardiologicznego pozycjonuje β-adrenolityki jako leki o fundamentalnym znaczeniu w leczeniu pacjentów z niewydolnością serca z obniżoną frakcją wyrzutową, arytmiami serca (w tym z migotaniem przedsionków), przewlekłym zespołem wieńcowym, po zawale z dysfunkcją lewej komory oraz z nadciśnieniem tętniczym przy wskazaniach towarzyszących. Bisoprolol jako długo działający kardioselektywny β-adrenolityk łączy przewidywalny ujemny efekt chronotropowy, działanie przeciwniedokrwienne i korzystny profil farmakokinetyczny z możliwością stosowania raz na dobę. Dane kliniczne potwierdzają jego znaczenie w kontrolowaniu częstości rytmu serca, poprawieniu rokowania w stabilnej niewydolności serca z obniżoną frakcją wyrzutową oraz w leczeniu pacjentów z wysokim ryzykiem sercowo-naczyniowym.
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Jak cytować
Zabłocki, O., & Ozierański, K. (2026). Miejsce bisoprololu we współczesnej kardiologii . Medycyna Faktów , 19(2(71), 222-227. https://doi.org/10.24292/01.MF.0226.12
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Artykuły
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Bibliografia
1. Van Gelder IC, Rienstra M, Bunting KV et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024; 45(36): 3314-414. http://doi.org/10.1093/eurheartj/ehae176.
2. Marti HP, Pavía López AA, Schwartzmann P. Safety and tolerability of β-blockers: importance of cardioselectivity. Curr Med Res Opin. 2024; 40(supl. 1): 55-62. http://doi.org/10.1080/03007995.2024.2317433.
3. Bennett M, Chang CL, Tatley M et al. The safety of cardioselective β1-blockers in asthma: literature review and search of global pharmacovigilance safety reports. ERJ Open Res. 2021; 7(1): 00801-2020. http://doi.org/10.1183/23120541.00801-2020.
4. Taddei S, Tsabedze N, Tan RS. β-blockers are not all the same: pharmacologic similarities and differences, potential combinations and clinical implications. Curr Med Res Opin. 2024; 40(supl. 1): 15-23. http://doi.org/10.1080/03007995.2024.2318058.
5. Leopold G. Balanced pharmacokinetics and metabolism of bisoprolol. J Cardiovasc Pharmacol. 1986; 8(Suppl. 11): S16-20. http://doi.org/10.1097/00005344-198511001-00003.
6. Tucker WD, Sankar P, Theetha Kariyanna P. Selective Beta-1 Blockers. 2023 Jan 30. In: StatPearls. StatPearls Publishing ; Treasure Island (FL) 2026.
7. Yamashita T, Inoue H. Heart rate-reducing effects of bisoprolol in Japanese patients with chronic atrial fibrillation: results of the MAIN-AF study. J Cardiol. 2013; 62(1): 50-7. http://doi.org/10.1016/j.jjcc.2013.02.010.
8. Van Gelder IC, Groenveld HF, Crijns HJ et al.; RACE II Investigators. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010; 362(15): 1363-73. http://doi.org/10.1056/NEJMoa1001337.
9. Kotecha D, Bunting KV, Gill SK et al; Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF) Team. Effect of Digoxin vs Bisoprolol for Heart Rate Control in Atrial Fibrillation on Patient-Reported Quality of Life: The RATE-AF Randomized Clinical Trial. JAMA. 2020; 324(24): 2497-508. http://doi.org/10.1001/jama.2020.23138.
10. Zeppenfeld K, Tfelt-Hansen J, de Riva M et al.; ESC Scientific Document Group. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022; 43(40): 3997-4126. http://doi.org/10.1093/eurheartj/ehac262.
11. A randomized trial of beta-blockade in heart failure. The Cardiac Insufficiency Bisoprolol Study (CIBIS). CIBIS Investigators and Committees. Circulation. 1994; 90(4): 1765-73. http://doi.org/10.1161/01.cir.90.4.1765.
12. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet. 1999; 353(9146): 9-13.
13. Leizorovicz A, Lechat P, Cucherat M et al. Bisoprolol for the treatment of chronic heart failure: a meta-analysis on individual data of two placebo-controlled studies – CIBIS and CIBIS II. Cardiac Insufficiency Bisoprolol Study. Am Heart J. 2002; 143(2): 301-7. http://doi.org/10.1067/mhj.2002.120768.
14. Frishman WH. Multifactorial actions of beta-adrenergic blocking drugs in ischemic heart disease: current concepts. Circulation. 1983; 67(6 Pt 2): I11-8.
15. Cruickshank JM. Are we misunderstanding beta-blockers. Int J Cardiol. 2007; 120(1): 10-27. http://doi.org/10.1016/j.ijcard.2007.01.069.
16. Byrne RA, Rossello X, Coughlan JJ et al.; ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023; 44(38): 3720-826. http://doi.org/10.1093/eurheartj/ehad191.
17. Munkhaugen J, Kristensen AMD, Halvorsen S et al.; BETAMI–DANBLOCK Investigators. Beta-Blockers after Myocardial Infarction in Patients without Heart Failure. N Engl J Med. 2025; 393(19): 1901-11. http://doi.org/10.1056/NEJMoa2505985.
18. Rossello X, Prescott EIB, Kristensen AMD et al. β blockers after myocardial infarction with mildly reduced ejection fraction: an individual patient data meta-analysis of randomised controlled trials. Lancet. 2025; 406(10508): 1128-37. http://doi.org/10.1016/S0140-6736(25)01592-2.
19. Kristensen AMD, Rossello X, Atar D et al.; Beta-Blocker Trialists’ Collaboration Study Group. Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction. N Engl J Med. 2026; 394(6): 540-50. http://doi.org/10.1056/NEJMoa2512686.
20. Shu de F, Dong BR, Lin XF et al. Long-term beta blockers for stable angina: systematic review and meta-analysis. Eur J Prev Cardiol. 2012; 19(3): 330-41. http://doi.org/10.1177/1741826711409325.
21. bbJouven X, Empana JP, Schwartz PJ et al. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med. 2005; 352(19): 1951-8. http://doi.org/10.1056/NEJMoa043012.
22. Sorbets E, Steg PG, Young R et al.; CLARIFY investigators. β-blockers, calcium antagonists, and mortality in stable coronary artery disease: an international cohort study. Eur Heart J. 2019; 40(18): 1399-407. http://doi.org/10.1093/eurheartj/ehy811.
23. Ford TJ, Stanley B, Good R et al. Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina: The CorMicA Trial. J Am Coll Cardiol. 2018; 72(23 Pt A): 2841-55. http://doi.org/10.1016/j.jacc.2018.09.006.
24. Cegłowska U, Burzyńska M, Prejbisz A et al. Incidence and prevalence of registered hypertension in Poland. Pol Arch Intern Med. 2024; 134(6): 16746. http://doi.org/10.20452/pamw.16746.
25. Symonides B, Jędrusik P, Artyszuk L et al. Different diagnostic criteria significantly affect the rates of hypertension in 18-year-old high school students. Arch Med Sci. 2010; 6(5): 689-94. http://doi.org/10.5114/aoms.2010.17082.
26. Botros SM, Hussein AM, Elserafy AS. Effect of different beta blockers on penile vascular velocities in hypertensive males. The Egyptian Journal of Radiology and Nuclear Medicine. 2015; 342: 749-54. http://doi.org/10.1016/j.ejrnm.2015.04.004.
27. Broekman CP, Haensel SM, Van de Ven LL et al. Bisoprolol and hypertension: effects on sexual functioning in men. J Sex Marital Ther. 1992; 18(4): 325-31. http://doi.org/10.1080/00926239208412857.
28. Meattini I, Becherini C, Martella F et al. Cardioprotection in patients with anthracycline-treated breast cancer: final analysis from the 2 × 2 randomized, placebo-controlled, double-blind SAFE trial. ESMO Open. 2025; 10(6): 105116. http://doi.org/10.1016/j.esmoop.2025.105116.
2. Marti HP, Pavía López AA, Schwartzmann P. Safety and tolerability of β-blockers: importance of cardioselectivity. Curr Med Res Opin. 2024; 40(supl. 1): 55-62. http://doi.org/10.1080/03007995.2024.2317433.
3. Bennett M, Chang CL, Tatley M et al. The safety of cardioselective β1-blockers in asthma: literature review and search of global pharmacovigilance safety reports. ERJ Open Res. 2021; 7(1): 00801-2020. http://doi.org/10.1183/23120541.00801-2020.
4. Taddei S, Tsabedze N, Tan RS. β-blockers are not all the same: pharmacologic similarities and differences, potential combinations and clinical implications. Curr Med Res Opin. 2024; 40(supl. 1): 15-23. http://doi.org/10.1080/03007995.2024.2318058.
5. Leopold G. Balanced pharmacokinetics and metabolism of bisoprolol. J Cardiovasc Pharmacol. 1986; 8(Suppl. 11): S16-20. http://doi.org/10.1097/00005344-198511001-00003.
6. Tucker WD, Sankar P, Theetha Kariyanna P. Selective Beta-1 Blockers. 2023 Jan 30. In: StatPearls. StatPearls Publishing ; Treasure Island (FL) 2026.
7. Yamashita T, Inoue H. Heart rate-reducing effects of bisoprolol in Japanese patients with chronic atrial fibrillation: results of the MAIN-AF study. J Cardiol. 2013; 62(1): 50-7. http://doi.org/10.1016/j.jjcc.2013.02.010.
8. Van Gelder IC, Groenveld HF, Crijns HJ et al.; RACE II Investigators. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010; 362(15): 1363-73. http://doi.org/10.1056/NEJMoa1001337.
9. Kotecha D, Bunting KV, Gill SK et al; Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF) Team. Effect of Digoxin vs Bisoprolol for Heart Rate Control in Atrial Fibrillation on Patient-Reported Quality of Life: The RATE-AF Randomized Clinical Trial. JAMA. 2020; 324(24): 2497-508. http://doi.org/10.1001/jama.2020.23138.
10. Zeppenfeld K, Tfelt-Hansen J, de Riva M et al.; ESC Scientific Document Group. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022; 43(40): 3997-4126. http://doi.org/10.1093/eurheartj/ehac262.
11. A randomized trial of beta-blockade in heart failure. The Cardiac Insufficiency Bisoprolol Study (CIBIS). CIBIS Investigators and Committees. Circulation. 1994; 90(4): 1765-73. http://doi.org/10.1161/01.cir.90.4.1765.
12. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet. 1999; 353(9146): 9-13.
13. Leizorovicz A, Lechat P, Cucherat M et al. Bisoprolol for the treatment of chronic heart failure: a meta-analysis on individual data of two placebo-controlled studies – CIBIS and CIBIS II. Cardiac Insufficiency Bisoprolol Study. Am Heart J. 2002; 143(2): 301-7. http://doi.org/10.1067/mhj.2002.120768.
14. Frishman WH. Multifactorial actions of beta-adrenergic blocking drugs in ischemic heart disease: current concepts. Circulation. 1983; 67(6 Pt 2): I11-8.
15. Cruickshank JM. Are we misunderstanding beta-blockers. Int J Cardiol. 2007; 120(1): 10-27. http://doi.org/10.1016/j.ijcard.2007.01.069.
16. Byrne RA, Rossello X, Coughlan JJ et al.; ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023; 44(38): 3720-826. http://doi.org/10.1093/eurheartj/ehad191.
17. Munkhaugen J, Kristensen AMD, Halvorsen S et al.; BETAMI–DANBLOCK Investigators. Beta-Blockers after Myocardial Infarction in Patients without Heart Failure. N Engl J Med. 2025; 393(19): 1901-11. http://doi.org/10.1056/NEJMoa2505985.
18. Rossello X, Prescott EIB, Kristensen AMD et al. β blockers after myocardial infarction with mildly reduced ejection fraction: an individual patient data meta-analysis of randomised controlled trials. Lancet. 2025; 406(10508): 1128-37. http://doi.org/10.1016/S0140-6736(25)01592-2.
19. Kristensen AMD, Rossello X, Atar D et al.; Beta-Blocker Trialists’ Collaboration Study Group. Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction. N Engl J Med. 2026; 394(6): 540-50. http://doi.org/10.1056/NEJMoa2512686.
20. Shu de F, Dong BR, Lin XF et al. Long-term beta blockers for stable angina: systematic review and meta-analysis. Eur J Prev Cardiol. 2012; 19(3): 330-41. http://doi.org/10.1177/1741826711409325.
21. bbJouven X, Empana JP, Schwartz PJ et al. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med. 2005; 352(19): 1951-8. http://doi.org/10.1056/NEJMoa043012.
22. Sorbets E, Steg PG, Young R et al.; CLARIFY investigators. β-blockers, calcium antagonists, and mortality in stable coronary artery disease: an international cohort study. Eur Heart J. 2019; 40(18): 1399-407. http://doi.org/10.1093/eurheartj/ehy811.
23. Ford TJ, Stanley B, Good R et al. Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina: The CorMicA Trial. J Am Coll Cardiol. 2018; 72(23 Pt A): 2841-55. http://doi.org/10.1016/j.jacc.2018.09.006.
24. Cegłowska U, Burzyńska M, Prejbisz A et al. Incidence and prevalence of registered hypertension in Poland. Pol Arch Intern Med. 2024; 134(6): 16746. http://doi.org/10.20452/pamw.16746.
25. Symonides B, Jędrusik P, Artyszuk L et al. Different diagnostic criteria significantly affect the rates of hypertension in 18-year-old high school students. Arch Med Sci. 2010; 6(5): 689-94. http://doi.org/10.5114/aoms.2010.17082.
26. Botros SM, Hussein AM, Elserafy AS. Effect of different beta blockers on penile vascular velocities in hypertensive males. The Egyptian Journal of Radiology and Nuclear Medicine. 2015; 342: 749-54. http://doi.org/10.1016/j.ejrnm.2015.04.004.
27. Broekman CP, Haensel SM, Van de Ven LL et al. Bisoprolol and hypertension: effects on sexual functioning in men. J Sex Marital Ther. 1992; 18(4): 325-31. http://doi.org/10.1080/00926239208412857.
28. Meattini I, Becherini C, Martella F et al. Cardioprotection in patients with anthracycline-treated breast cancer: final analysis from the 2 × 2 randomized, placebo-controlled, double-blind SAFE trial. ESMO Open. 2025; 10(6): 105116. http://doi.org/10.1016/j.esmoop.2025.105116.