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Effect of Carvedilol Versus Metoprolol CR/XL on Mortality in Patients With Heart Failure Treated With Cardiac Resynchronization Therapy: A COX Multivariate Regression Analysis.
MedLine Citation:
PMID:  21642836     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We investigated in 136 consecutive patients with heart failure receiving cardiac resynchronization therapy (CRT) the effect of carvedilol versus metoprolol CR/XL versus no beta blocker on mortality. Of the 136 patients, 42 (31%) were on carvedilol, 80 (59%) were on metoprolol CR/XL, and 14 (10%) were not on a beta blocker. A decrease of left ventricular end-systolic volume ≥15% after CRT was defined as a positive response to CRT. Of the 136 patients, 62 (46%) responded to CRT. It was found that both carvedilol and metoprolol CR/XL were not related to CRT response on using Cox univariate regression analysis. Twenty-two of the 136 patients (16%) died during follow-up of 17 ± 10 months after initiating CRT. Mortality occurred in 14 of 80 patients (18%) on metoprolol CR/XL, in 3 of 42 patients (7%) on carvedilol, and in 5 of 14 patients (36%) not on beta blockers (P = 0.04). After adjustment for age, gender, and the variables with significant differences by Cox univariate regression, both carvedilol (hazard ratio = 0.14; P = 0.03; 95% confidence interval = 0.02-0.86) and metoprolol CR/XL (hazard ratio = 0.19; P = 0.02; 95% confidence interval = 0.04-0.80) were found to be related to mortality by Cox multivariate regression.
Authors:
Xuedong Shen; Chandra K Nair; Wilbert S Aronow; Tom Hee; Dennis J Esterbrooks
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-03
Journal Detail:
Title:  American journal of therapeutics     Volume:  -     ISSN:  1536-3686     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9441347     Medline TA:  Am J Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Cardiac Center of Creighton University School of Medicine, Omaha, NE; and 2Cardiology Division, Department of Medicine, New York Medical College, Valhalla, NY.
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