Nebivolol versus Carvedilol or Metoprolol in Patients Presenting with Acute Myocardial Infarction Complicated by Left Ventricular Dysfunction

Abstract

Objective: The aim of this study was to evaluate the efficacy of nebivolol, carvedilol or metoprolol succinate on the outcome of patients presenting with acute myocardial infarction (AMI) complicated by left ventricular dysfunction. Subjects and Methods: Patients (n = 172, aged 28-87 years) with AMI and left ventricular ejection fraction ≤0.45 were randomized to the nebivolol (n = 55), carvedilol (n = 60) and metoprolol succinate (n = 57) groups. Baseline demographic and clinical characteristics and composite event rates of nonfatal MI, cardiovascular mortality, hospitalization due to unstable angina pectoris or heart failure, stroke or revascularization during the 12-month follow-up were compared among the groups using the χ² test, t test or log-rank test as appropriate. Results: Baseline demographic and clinical characteristics were similar in the three groups. The composite end point during follow-up was lower in the patients treated with nebivolol than those treated with metoprolol (14.5 vs. 31.5%; p = 0.03). However, event rates were similar between the patients treated with carvedilol and those treated with the metoprolol (20.3 vs. 31.5%, p > 0.05) and between the patients treated with nebivolol and carvedilol (14.5 vs. 20.3%, p > 0.05). Conclusion: Thepatients treated with nebivolol experienced 12-month cardiovascular events at a lower rate than those treated with metoprolol succinate. However, event rates were similar between the carvedilol and the metoprolol succinate groups and between the nebivolol and the carvedilol groups.

Therapeutic Properties of Highly Selective β-blockers With or Without Additional Vasodilator Properties: Focus on Bisoprolol and Nebivolol in Patients With Cardiovascular Disease

“…ECG ST segment elevation was significantly lower after randomisation to nebivolol vs. atenolol, in patients with documented CHD in patients undergoing exercise testing within a randomised trial [ 92 ]. A one-year randomised trial evaluated nebivolol in comparison with metoprolol and carvedilol in 172 patients with acute MI complicated by left ventricular dysfunction [ 93 ]. A composite outcome of nonfatal MI, cardiovascular death, hospitalisation for unstable angina pectoris or heart failure, stroke or revascularisation was significantly lower in the nebivolol vs. metoprolol groups (14.5 vs. 31.5%; p = 0.03), with no significant (p > 0.05) trends for benefit with for nebivolol vs. carvedilol (14.5 vs. 20.3%) and carvedilol vs. metoprolol (20.3 vs. 31.5%, p > 0.05).…”

Zastosowanie bursztynianu metoprololu w leczeniu niewydolności serca oraz migotania przedsionków: przegląd systematyczny

“…W niedawno opublikowanym badaniu randomizowanym porównano skuteczność nebiwololu, karwedylolu oraz bursztynianu metoprololu u pacjentów zgłaszających się z powodu ostrego MI powikłanego dysfunkcją lewej komory (LVEF ≤ 45%) [25]. Losowo przydzielono pacjentów (n = 172, 28-87 lat) do leczenia nebiwololem (n = 55), karwedylolem (n = 60) lub metoprololem (n = 57).…”

Nebivolol: Does the key lie in β3 agonism?

“…In acute coronary syndromes, a small-scale study showed that patients that had an infarction with ventricular dysfunction had fewer events (infarction/death/hospitalization due to coronary syndrome/ stroke or need of revascularization) over 12 months than those patients treated with Metoprolol and similar to those treated with Carvedilol [73].…”