In a nutshell
This study compared the use of two beta-blockers, carvedilol (Coreg) and metoprolol (Lopressor), after a heart attack. It found that they had similar results on most patient groups. However, carvedilol improved survival in patients with reduced heart function.
Some background
Beta-blockers are a group of medications that slow the heart rate. They are commonly used after a heart attack to allow the heart to rest. Sometimes when the heart is badly damaged after a heart attack patients can develop heart failure. Heart failure is measured by how much of the blood that enters the heart is pumped out with every beat. This is called the ejection fraction. The lower the ejection fraction, the more severe the heart failure.
There are many types of beta-blockers and it is not known which is best for improving survival after a heart attack.
Methods & findings
5,629 patients were involved in this study. All patients had had a heart attack. 4,142 were treated with metoprolol, and 1,487 were treated with carvedilol.
The 3-year survival rate was 88.2% in the metoprolol group and 83.5% in the carvedilol group. However, the carvedilol patients were sicker to begin with. When this was taken into account, the survival rates in the two groups were very similar. Only patients with heart failure and an ejection fraction of <40% did better on carvedilol.
The bottom line
This study showed that overall, survival rates after a heart attack were similar with carvedilol and metoprolol. However, patients with heart failure and an ejection fraction <40% may do better on carvedilol.
The fine print
This study was based on medical records. Patients were not randomly assigned to one drug or another. More studies are needed to confirm these results.
Published By :
The American journal of cardiology
Date :
Feb 20, 2021
