Key result
Metoprolol succinate was beta(1)-selective at low doses but became progressively nonselective at higher doses, whereas carvedilol was nonselective at all clinically relevant doses.
Why the study?
Does metoprolol succinate remain beta(1)-selective compared with carvedilol during upward titration of doses in patients with ACC stage C heart failure?
RCT (n=25)
parallel-arm
No
Does metoprolol succinate remain beta(1)-selective compared with carvedilol during upward titration of doses in patients with ACC stage C heart failure?
In heart failure patients, carvedilol is nonselective at all clinically relevant doses, whereas metoprolol succinate is beta(1)-selective at low doses but becomes progressively nonselective at higher doses.
Alerts clinicians to selectivity loss during metoprolol titration in HF; extends RCT evidence on dose-dependent beta-blocker profiles.
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Zebrack et al. (2009) conducted an RCT in Heart failure (ACC stage C) (n=25). Metoprolol succinate vs. Carvedilol (3.125 mg twice/day titrated up to 25 mg twice/day) was evaluated on Degree of beta(2)-blockade assessed by glucose and potassium AUC during terbutaline infusion. Metoprolol succinate was beta(1)-selective at low doses but became progressively nonselective at higher doses, whereas carvedilol was nonselective at all clinically relevant doses.
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