Key result
Long-term carvedilol therapy did not significantly reduce the composite of all-cause death, myocardial infarction, or hospitalization for heart failure or acute coronary syndrome compared to no beta-blocker in STEMI patients treated with primary PCI (HR 0.75).
Why the study?
Does long-term carvedilol therapy reduce the composite of all-cause death, myocardial infarction, hospitalization for heart failure, and hospitalization for acute coronary syndrome in uncomplicated STEMI patients treated with primary PCI?
RCT (n=801)
Open-label
1-to-1 stochastic minimization algorithm
Yes
Does long-term carvedilol therapy reduce the composite of all-cause death, myocardial infarction, hospitalization for heart failure, and hospitalization for acute coronary syndrome in uncomplicated STEMI patients treated with primary PCI?
Hazard Ratio: 0.75 (95% CI 0.47–1.16)
Absolute Event Rate: 6.8% vs 7.9%
p-value: p=0.20
Long-term carvedilol therapy did not improve clinical outcomes in uncomplicated STEMI patients with preserved LVEF treated with primary PCI, challenging current guideline recommendations for routine beta-blocker use in this population.
No takes yet. Share an insight, caveat, or question.
Supports withholding routine beta-blockers in uncomplicated STEMI with preserved LVEF; challenges decades.
Watanabe et al. (2018) conducted an RCT in ST-segment elevation myocardial infarction (STEMI) (n=801). Carvedilol vs. No beta-blocker was evaluated on Composite of all-cause death, myocardial infarction, hospitalization for heart failure, and hospitalization for acute coronary syndrome (HR 0.75, 95% CI 0.47-1.16, p=0.20). Long-term carvedilol therapy did not significantly reduce the composite of all-cause death, myocardial infarction, or hospitalization for heart failure or acute coronary syndrome compared to no beta-blocker in STEMI patients treated with primary PCI (HR 0.75).
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