Randomized active-controlled study comparing effects of treatment with carvedilol versus metoprolol in patients with left ventricular dysfunction after acute myocardial infarction - 16/08/11
, Lidija Zlatimir Savic, MD b, Jovan Petar Perunicic, PhD a, Milika Risto Asanin, MD a, Ratko Milorad Lasica, MD a, Marinkovic Milutin Jelena, PhD c, Mihailo Dragomir Matic, PhD a, Zorana Mihailo Vasiljevic, PhD a, Miodrag Caslav Ostojic, PhD dRésumé |
Background |
Carvedilol has previously been demonstrated to be beneficial in patients with acute myocardial infarction (AMI) and left ventricular (LV) dysfunction. However, metoprolol has not to date been randomly evaluated in the same patient population. The objective of this study was to compare the effects of treatment with carvedilol versus metoprolol in patients with LV dysfunction after AMI.
Methods |
The study enrolled 313 high-risk patients with anterior AMI and LV ejection fraction of <45%, randomly assigned to treatment with carvedilol or metoprolol. Patients were followed-up for a mean period of 13.4 months. The primary end point was time to composite adverse events (t-CAE). The secondary end points were time to composite hard events (t-CHE) and health-related quality of life.
Results |
No differences were found either in the primary end point of t-CAE or in the secondary end point of t-CHE. A significant benefit was observed in 4 of 8 health-related quality of life domains in the carvedilol group, with fewer carvedilol group patients being withdrawn from therapy in the hospital.
Conclusions |
Treatment with carvedilol, in comparison to that with metoprolol in patients with AMI and LV dysfunction, did not differ significantly in regard to the primary end point of t-CAE or to the secondary end point of t-CHE but resulted in better long-term quality of life and favorable early safety profile.
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| IM conceived the study. IM and RL performed echocardiographic examination and allocated patients to randomized treatment. JP, MA, and MM were responsible for the regular 6-month follow-up. LS conducted the SF-36 interviews. JM analyzed data. IM, ZV, and MO discussed data. All authors approved the final manuscript. |
Vol 154 - N° 1
P. 116-122 - juillet 2007 Retour au numéro
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