Comparison of safety and efficacy of carvedilol and metoprolol in stable angina pectoris

Does, R. van der; Hauf-Zachariou, U.; Pfarr, Egon; Holtbrügge, Werner; König, Steffen; Griffiths, Mark; Lahiri, Avijit

doi:10.1016/s0002-9149(98)00960-6

Cited by 25 publications

(9 citation statements)

References 17 publications

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“…were assessed in comparison with metoprolol (50-100 mg, b.i.d.) (105). Although both drugs showed good antianginal and antiischemic efficacy, the improvement in exercise tolerance by carvedilol, estimated by ST-T segment depression, was greater than that by metoprolol when compared at doses causing equivalent â-adrenoceptor blockade.…”

Section: Ischemic Heart Diseasementioning

confidence: 93%

Carvedilol: Molecular and Cellular Basis for Its Multifaceted Therapeutic Potential

Cheng

Kamiya

Kodama

2001

Cardiovascular Drug Reviews

115

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Carvedilol is a unique cardiovascular drug of multifaceted therapeutic potential. Its major molecular targets recognized to date are membrane adrenoceptors (â 1 , â 2 , and á 1 ), reactive oxygen species, and ion channels (K + and Ca 2+ ). Carvedilol provides prominent hemodynamic benefits mainly through a balanced adrenoceptor blockade, which causes a reduction in cardiac work in association with peripheral vasodilation. This drug assures remarkable cardiovascular protection through its antiproliferative/atherogenic, antiischemic, antihypertrophic, and antiarrhythmic actions. These actions are a consequence of its potent antioxidant effects, amelioration of glucose/lipid metabolism, modulation of neurohumoral factors, and modulation of cardiac electrophysiologic properties. The usefulness of carvedilol in the treatment of hypertension, ischemic heart disease, and congestive heart failure is based on a combination of hemodynamic benefits and cardiovascular protection.

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Section: Ischemic Heart Diseasementioning

confidence: 93%

Carvedilol: Molecular and Cellular Basis for Its Multifaceted Therapeutic Potential

Cheng

Kamiya

Kodama

2001

Cardiovascular Drug Reviews

115

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“…In patients with hypertension, only about 50% are classified as responders to treatment, although variable efficacy in other disease states is less well defined. 6,7 In addition, as many as 25% to 30% of patients have adverse effects, 8 depending on dose and patient health, with some patients requiring discontinuation of therapy.…”

mentioning

confidence: 99%

Pharmacokinetics and genotypes do not predict metoprolol adverse events or efficacy in hypertension

Zineh

Beitelshees

Gaedigk

et al. 2004

Clinical Pharmacology & Therapeutics

141

125

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“…Follow-up LVEFs were obtained by echocardiography between six and twelve months after completion of beta-blocker titration, and were compared to the baseline measurements so as to categorize a patient’s LVEF as worsened, unchanged, or improved. Beta-blocker doses were converted to metoprolol equivalent doses based on comparative studies between metoprolol, atenolol,20 and carvedilol 21. Claims for ED visits and hospitalizations were examined to determine the presence of HF- and COPD-related diagnoses recorded during the ED visit/hospitalization.…”

Section: Methodsmentioning

confidence: 99%

Beta-blocker therapy in patients with left ventricular systolic dysfunction and chronic obstructive lung disease in an ambulatory care setting

Schimmer

Billups

Delate

2009

Pharmacy Practice (Internet)

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Objective:To evaluate beta blocker persistence six months after beta-blocker initiation or dose titration in heart failure (HF) patients with COPD compared to those without COPD. Secondary objectives included comparison of beta-blocker dose achieved, changes in left ventricular ejection fraction (LVEF) and incidence of hospitalizations or emergency department (ED) visits during follow-up.Methods:We conducted a matched, retrospective, cohort study including 86 patients with COPD plus concomitant HF (LVEF ≤40%) and 137 patients with HF alone. All patients were followed in an outpatient HF clinic. Eligible patients had a documented LVEF ≤40% and were initiated or titrated on a beta-blocker in the HF clinic. Patients were matched based on LVEF (categorized as ≤ 20% or 21-40%), gender, and age (> or ≤70 years). The primary outcome was beta blocker persistence at 6 months. Secondary outcomes were dose achieved, LVEF, and incidence of hospitalizations or ED visits.Results:There were no differences between the COPD and non-COPD groups in beta-blocker persistence at six-month follow-up (94.2% vs. 93.4% respectively, adjusted p=0.842). The proportion of patients who achieved a daily metoprolol dose equivalent of at least 100 mg was similar between the groups (adjusted p=0.188). The percent of patients with at least one ED visit or hospitalization in the six-month post-titration period was substantial but similar between the groups (53.5% and 48.2% for COPD and non-COPD patients, respectively, adjusted p=0.169).Conclusion:Our results support the use of beta-blockers in the population of heart failure patients with COPD and without reactive airway disease.

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Comparison of safety and efficacy of carvedilol and metoprolol in stable angina pectoris

Cited by 25 publications

References 17 publications

Carvedilol: Molecular and Cellular Basis for Its Multifaceted Therapeutic Potential

Carvedilol: Molecular and Cellular Basis for Its Multifaceted Therapeutic Potential

Pharmacokinetics and genotypes do not predict metoprolol adverse events or efficacy in hypertension

Beta-blocker therapy in patients with left ventricular systolic dysfunction and chronic obstructive lung disease in an ambulatory care setting

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