Document Detail


Carvedilol or sustained-release metoprolol for congestive heart failure: a comparative effectiveness analysis.
MedLine Citation:
PMID:  23207080     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Relative effectiveness of carvedilol and metoprolol succinate has never been compared in patients with heart failure (HF).
METHODS AND RESULTS: From January 1998 to December 2008, 3,716 consecutive patients with ejection fraction (EF) ≤40%, initiated and maintained on carvedilol or metoprolol succinate, were enrolled and followed until June 2010. The primary end point was all-cause mortality, and the secondary end points were readmissions from HF and follow up EFs at 1, 3, and 5 years. HF etiology (ischemic or nonischemic) was a significant effect modifier, and separate analysis was performed for these subcohorts. Compared with those on carvedilol, patients on metoprolol succinate were less likely to experience mortality in the ischemic HF cohort (adjusted hazard ratio [aHR] 0.54, 95% confidence interval [CI] 0.43-0.66) but were more likely to die in the nonischemic HF cohort (aHR 1.18, 95% CI 1.10-1.28). Follow-up EF was similar by type of beta-blocker used in both ischemic and nonischemic HF cohorts. Furthermore, no significant difference was noted in the incidence of HF hospitalizations by beta-blocker type used in both ischemic and nonischemic HF cohorts.
CONCLUSIONS: Metoprolol succinate was associated with an improved survival in patients with ischemic HF, and carvedilol was associated with an improved survival in patients with nonischemic HF.
Authors:
Supriya Shore; Vikas Aggarwal; Ronald Zolty
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  18     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-04     Completed Date:  2013-05-24     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  919-24     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, The Bronx, New York 10461, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Carbazoles / therapeutic use*
Cardiomyopathies / complications
Cohort Studies
Delayed-Action Preparations
Female
Follow-Up Studies
Heart Failure / drug therapy*,  etiology,  mortality*
Hospitalization / statistics & numerical data
Humans
Male
Metoprolol / analogs & derivatives*,  therapeutic use
Middle Aged
Myocardial Ischemia / complications
Propanolamines / therapeutic use*
Proportional Hazards Models
Stroke Volume
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Delayed-Action Preparations; 0/Propanolamines; 0K47UL67F2/carvedilol; 37350-58-6/Metoprolol; TH25PD4CCB/metoprolol succinate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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