Key result
Carvedilol shows no benefit in STEMI with LVEF ≥40% but cuts events ~68% when LVEF <55%.
Why the study?
The benefits of long-term oral beta-blocker therapy in patients with STEMI and mildly reduced LVEF (>=40%) remain unknown.
Does carvedilol reduce the composite of all-cause death, myocardial infarction, hospitalization for acute coronary syndrome, and hospitalization for heart failure in patients with STEMI and successful PCI with LVEF ≥40%?
RCT (n=794)
randomly assigned
Does carvedilol reduce the composite of all-cause death, myocardial infarction, hospitalization for acute coronary syndrome, and hospitalization for heart failure in patients with STEMI and successful PCI with LVEF ≥40%?
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Long-term carvedilol therapy may be beneficial for preventing cardiac-related events in STEMI patients with successful PCI and mildly reduced LVEF (<55%), but not in those with normal LVEF.
Amano et al. (2023) conducted an RCT in ST-segment elevation myocardial infarction with mildly reduced left ventricular ejection fraction (n=794). Carvedilol vs. No β-blocker therapy was evaluated on composite of all-cause death, myocardial infarction, hospitalization for acute coronary syndrome, and hospitalization for heart failure. Carvedilol therapy did not significantly reduce the primary composite endpoint in STEMI patients with LVEF ≥40%, but reduced cardiac events in those with LVEF <55% (HR 0.32; 95% CI 0.10-0.99).
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