Document Detail

Carvedilol administration in acute myocardial infarction results in stronger inhibition of early markers of left ventricular remodeling than metoprolol.
MedLine Citation:
PMID:  20864196     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The structural secuelae of acute myocardial infarction (AMI) is mostly dictated by left ventricular (LV) remodelling, leading to heart failure. Monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) play a critical role in LV remodelling. β-blockers are first line therapy for AMI and heart failure; however, the mechanisms responsible for their benefits remain poorly understood. Different β-blocker agents have been shown to exert beneficial activities both in AMI and heart failure, however, their role in early remodelling after ischemia/reperfusion is to be fully elucidated. We sought to compare the effect of 2 of the most prescribed β-blocker agents in early markers of LV remodelling after AMI.
METHODS: A reperfused AMI was induced in Yorshire pigs, being randomized to early intravenous carvedilol, metoprolol or placebo. Twenty-four hours after reperfusion markers of early remodelling were addressed in the LV.
RESULTS: The early administration of both β-blockers is able to significantly reduce macrophage infiltration as well as the expression and activity of MCP-1 and MMP-2 compared to placebo. The effects of carvedilol were much stronger than those of metoprolol. Conversely, carvedilol upregulated the expression TIMP-2 to a greater extent than metoprolol.
CONCLUSIONS: In an AMI model closely mimicking human pathophysiology, the early administration of carvedilol reduced the expression of markers associated with early LV remodelling to greater extent than metoprolol. These findings may explain the superior clinical benefits exerted by carvedilol in heart failure.
Giovanni Cimmino; Borja Ibanez; Chiara Giannarelli; Susanna Prat-González; Randolph Hutter; Mario Garcia; Javier Sanz; Valentin Fuster; Juan J Badimon
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-22
Journal Detail:
Title:  International journal of cardiology     Volume:  153     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-23     Completed Date:  2012-08-20     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  256-61     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Atherothrombosis Research Unit, Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY 10029, USA.
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MeSH Terms
Biological Markers / metabolism
Carbazoles / pharmacology,  therapeutic use*
Down-Regulation / drug effects*
Metoprolol / pharmacology,  therapeutic use*
Myocardial Infarction / drug therapy*,  metabolism,  pathology
Propanolamines / pharmacology,  therapeutic use*
Random Allocation
Ventricular Remodeling / drug effects*,  physiology
Reg. No./Substance:
0/Biological Markers; 0/Carbazoles; 0/Propanolamines; 0K47UL67F2/carvedilol; 37350-58-6/Metoprolol

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