Key result
Carvedilol added to ACE inhibitors post-CABG yielded lower LVEF improvement at 1 month (15.3% vs 29.1%) but significantly greater LVEF levels at 3 and 6 months compared to ACE inhibitors alone.
Why the study?
Does carvedilol added to ACE inhibitor therapy improve left ventricular contractility in patients with ischemic left ventricular systolic dysfunction undergoing CABG?
Cohort (n=141)
Does carvedilol added to ACE inhibitor therapy improve left ventricular contractility in patients with ischemic left ventricular systolic dysfunction undergoing CABG?
Answers are grounded in this paper and cite their sources.
Adding carvedilol to ACE inhibitor therapy after CABG in patients with severe ischemic LV dysfunction improves LV contractility and remodeling at 6 months, despite a slower initial recovery at 1 month.
Studies are scant on the effects of short-term carvedilol treatment as an adjuvant to angiotensin-converting enzyme (ACE) inhibitor in patients with left ventricular (LV) systolic dysfunction. The objective of this study was to find the effects of short-term treatment of carvedilol on patients with ischemic LV systolic dysfunction (defined as LV ejection fraction (LVEF) <or=30% on 2D echocardiography) undergoing coronary artery bypass surgery (CABG). There were 74 patients that received ACE inhibitor without any beta-blocker (control) and 67 patients that received carvedilol in addition to ACE inhibitor following CABG (carvedilol group). After 1 month of drug administration following CABG, the control group was found to have significantly greater percent improvement in LVEF (29.1% +/- 5.39%) as compared with the carvedilol group (15.3% +/- 4.89%). However, after 3 and 6 months, LVEF levels were found to be significantly greater in the carvedilol group as compared with the control group. Further, at 6 months of drug administration, LV end systolic diameter was significantly less in the carvedilol group (39.11 +/- 1.10 mm) as compared with the control group (43.49 +/- 1.39 mm). Thus, carvedilol produces beneficial effect on short-term administration in terms of LV contractility when given along with ACE inhibitor as compared with ACE inhibitor therapy alone.
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Gandhi et al. (2007) conducted a cohort in Ischemic left ventricular systolic dysfunction (n=141). Carvedilol in addition to ACE inhibitor vs. ACE inhibitor without any beta-blocker was evaluated on Percent improvement in LVEF at 1 month. Carvedilol added to ACE inhibitors post-CABG yielded lower LVEF improvement at 1 month (15.3% vs 29.1%) but significantly greater LVEF levels at 3 and 6 months compared to ACE inhibitors alone.
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