Why the study?
Most systematic reviews and meta-analyses comparing bisoprolol and carvedilol in HFrEF have focused on Western populations, leaving their comparative efficacy in Asian populations unclear.
Does bisoprolol improve all-cause mortality, hospitalization, and LVEF compared to carvedilol in Asian patients with HFrEF?
Does bisoprolol improve all-cause mortality, hospitalization, and LVEF compared to carvedilol in Asian patients with HFrEF?
Bisoprolol and carvedilol demonstrate comparable efficacy regarding mortality, hospitalization, and LVEF improvement in Asian patients with HFrEF.
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Informs beta-blocker selection in Asian HFrEF; extends Western meta-analyses to high-burden populations.
China, Indonesia, and Malaysia have the highest age-standardized rates of heart failure in Asia, according to the Global Burden of Disease study. While numerous systematic reviews and meta-analyses have compared bisoprolol and carvedilol in HFrEF, most have focused on Western populations. To address this gap, we conducted a meta-analysis of RCTs and cohort studies involving Asian patients with HFrEF from PubMed and Cochrane databases that reported all-cause mortality, hospital admission, and left ventricular ejection fraction (LVEF) increase. The search result identified five eligible studies, primarily from Taiwan, Japan, and South Korea, with a total of 11,577 participants. The meta-analysis revealed no significant difference between bisoprolol and carvedilol in terms of all-cause mortality (RR 1.04, p 0.62, I 2 = 0%), hospitalization (RR 1.23, p. 0.23, I 2 = 0%), and LVEF increase (RR -1.40, p. 0.50, I 2 = 0%). These findings suggest that both drugs have comparable efficacy in the Asian population.
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Sukmawan et al. (2025) studied this question.
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