In heart failure patients receiving CRT, carvedilol (HR 0.14; 95% CI 0.02-0.86) and metoprolol CR/XL (HR 0.19; 95% CI 0.04-0.80) were associated with significantly lower mortality than no beta blocker.
Cohort (n=136)
Does carvedilol or metoprolol CR/XL reduce mortality compared to no beta blocker in patients with heart failure receiving cardiac resynchronization therapy?
In heart failure patients receiving cardiac resynchronization therapy, treatment with either carvedilol or metoprolol CR/XL is associated with significantly lower mortality compared to no beta-blocker therapy.
Hazard Ratio: 0.14 (95% CI 0.02–0.86)
Absolute Event Rate: 7% vs 36%
p-value: p=0.03
We investigated in 136 consecutive patients with heart failure receiving cardiac resynchronization therapy (CRT) the effect of carvedilol versus metoprolol CR/XL versus no beta blocker on mortality. Of the 136 patients, 42 (31%) were on carvedilol, 80 (59%) were on metoprolol CR/XL, and 14 (10%) were not on a beta blocker. A decrease of left ventricular end-systolic volume ≥15% after CRT was defined as a positive response to CRT. Of the 136 patients, 62 (46%) responded to CRT. It was found that both carvedilol and metoprolol CR/XL were not related to CRT response on using Cox univariate regression analysis. Twenty-two of the 136 patients (16%) died during follow-up of 17 ± 10 months after initiating CRT. Mortality occurred in 14 of 80 patients (18%) on metoprolol CR/XL, in 3 of 42 patients (7%) on carvedilol, and in 5 of 14 patients (36%) not on beta blockers (P = 0.04). After adjustment for age, gender, and the variables with significant differences by Cox univariate regression, both carvedilol (hazard ratio = 0.14; P = 0.03; 95% confidence interval = 0.02-0.86) and metoprolol CR/XL (hazard ratio = 0.19; P = 0.02; 95% confidence interval = 0.04-0.80) were found to be related to mortality by Cox multivariate regression.
Shen et al. (Fri,) conducted a cohort in Heart failure treated with cardiac resynchronization therapy (n=136). Carvedilol or metoprolol CR/XL vs. No beta blocker was evaluated on Mortality (HR 0.14, 95% CI 0.02-0.86, p=0.03). In heart failure patients receiving CRT, carvedilol (HR 0.14; 95% CI 0.02-0.86) and metoprolol CR/XL (HR 0.19; 95% CI 0.04-0.80) were associated with significantly lower mortality than no beta blocker.