Key result
In post-MI patients with LVEF <40%, carvedilol reduced total mortality compared to placebo (11.9% vs 15.3%; ARR 3.4%; NNT 28).
Why the study?
Does carvedilol reduce total mortality in post-MI patients with LVEF <40% receiving modern secondary prophylaxis?
Population
1959 post-myocardial infarction patients with left ventricular ejection fraction <40%
Comparison
Carvedilol added to modern secondary prophylaxis… vs Placebo added to modern secondary prophylaxis…
Design
Review, randomised
Follow-up
mean 15 months
Authors
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Supports carvedilol mortality benefit in post-MI LVEF<40% on modern therapy; leaves open optimal agent choice in evolving regimens.
RCT (n=1,959)
randomized
Does carvedilol reduce total mortality in post-MI patients with LVEF <40% receiving modern secondary prophylaxis?
Absolute Risk Reduction: 3.4
Absolute Event Rate: 11.9% vs 15.3%
Absolute Risk Reduction: 3.4%
Number Needed to Treat: 28
Carvedilol significantly reduces mortality and recurrent MI in post-MI patients with LV dysfunction, confirming the benefit of beta-blockers on top of modern ACEi/statin therapy.
Otterstad et al. (2002) conducted an RCT in post-myocardial infarction with impaired left ventricular systolic function (n=1,959). Carvedilol vs. Placebo was evaluated on total mortality (RRR 23%). In post-MI patients with LVEF <40%, carvedilol reduced total mortality compared to placebo (11.9% vs 15.3%; ARR 3.4%; NNT 28).
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