Key result
Carvedilol significantly reduced adverse cardiac events compared to placebo (7.1% vs 22.2%; P=0.04) over 6 months in clinically stable patients post-myocardial infarction and thrombolysis.
Why the study?
Does carvedilol reduce adverse cardiac events in clinically stable patients 6 weeks post-myocardial infarction and thrombolysis?
RCT (n=101)
Double-blind
parallel group
Does carvedilol reduce adverse cardiac events in clinically stable patients 6 weeks post-myocardial infarction and thrombolysis?
Absolute Event Rate: 7.1% vs 22.2%
p-value: p=0.04
Carvedilol significantly reduces adverse cardiac events over 6 months in clinically stable patients, particularly those with reversible ischemia, 6 weeks post-myocardial infarction and thrombolysis.
Supports carvedilol in stable post-MI patients after thrombolysis; extends beta-blocker benefit to the subacute phase.
The majority of post-myocardial infarction studies with beta-blocking drugs involved earlier generations. Newer drugs of this family with additional vasodilating and free-radical suppression properties, such as carvediol, are now available which may improve the prognosis still further. This double-blind, randomized, placebo-controlled, parallel group study was designed to assess the extent of myocardial ischaemia in clinically stable patients 6 weeks after acute myocardial infarction and thrombolysis, and to determine the influence of carvedilol on ischaemic events during the subsequent 6 months. One hundred and one patients who remained event free at 6 weeks post myocardial infarction underwent rest and exercise thallium-201 (TI-201) imaging. Reversible ischaemia was detected in 70 of the patients and there were 13 events in this group compared to one event in the 31 patients without ischaemia (P = 0.07). Four of the 56 patients on carvedilol and 10 of the 45 on placebo had adverse cardiac events (P = 0.04). In patients with reversible ischaemia carvedilol was more effective in reducing these events than was placebo (P = 0.03). These studies demonstrate that reversible myocardial ischaemia detected by TI-201 imaging is present in a large proportion of clinically stable patients following thrombolysis. In these patients, there is an increased cardiac event rate which is significantly reduced by carvedilol.
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Basu et al. (1996) conducted an RCT in acute myocardial infarction (n=101). carvedilol vs. placebo was evaluated on adverse cardiac events (p=0.04). Carvedilol significantly reduced adverse cardiac events compared to placebo (7.1% vs 22.2%; P=0.04) over 6 months in clinically stable patients post-myocardial infarction and thrombolysis.
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