Thursday, March 08, 2007
beta-blocker carvedilol
Carvedilol May Be More Anti-Ischemic Than Other Beta-Blockers
Sue Hughes
Heartwire 2007. © 2007 Medscape
February 26, 2007 (Rhoon, the Netherlands) - A new analysis of the COMET study shows that carvedilol reduces vascular events to a greater extent than metoprolol, an effect that the authors suggest likely contributes to the superior therapeutic profile of carvedilol in the treatment of heart failure.
The current analysis, published in the March 6, 2007 issue of the Journal of the American College of Cardiology [1], was conducted by a group led by Dr Willem J Remme (Sticares Cardiovascular Research Institute, Rhoon, the Netherlands).
They note that carvedilol has a unique pharmacologic profile, blocking both beta-1 and -2 adrenergic receptors, and has tighter, more prolonged binding to the beta-1 receptor than metoprolol, which results in a greater sympathoinhibitory activity. The COMET trial was conducted to investigate whether these properties would lead to better outcomes with carvedilol compared with metoprolol tartrate, a beta-1-selective beta blocker, in more than 3000 heart-failure patients, and the primary results, published in 2003, did indeed show improved rates of survival and cardiovascular hospitalizations in patients receiving carvedilol. But the results have been challenged by some other heart-failure experts, who have pointed out that metoprolol was not given at the optimum dose or formulation in COMET and that the better effect of carvedilol could have been caused simply by a greater effect on beta-1 blockade alone, which could be seen with optimum doses of any beta blocker.
The current analysis was conducted to investigate whether vascular protection could have contributed to the superior effect of carvedilol in the COMET trial and therefore focused on the vascular end points of cardiovascular death, stroke, stroke death, MI, and unstable angina. Results showed a consistently greater effect on these events with carvedilol than with metoprolol.
Sue Hughes
Heartwire 2007. © 2007 Medscape
February 26, 2007 (Rhoon, the Netherlands) - A new analysis of the COMET study shows that carvedilol reduces vascular events to a greater extent than metoprolol, an effect that the authors suggest likely contributes to the superior therapeutic profile of carvedilol in the treatment of heart failure.
The current analysis, published in the March 6, 2007 issue of the Journal of the American College of Cardiology [1], was conducted by a group led by Dr Willem J Remme (Sticares Cardiovascular Research Institute, Rhoon, the Netherlands).
They note that carvedilol has a unique pharmacologic profile, blocking both beta-1 and -2 adrenergic receptors, and has tighter, more prolonged binding to the beta-1 receptor than metoprolol, which results in a greater sympathoinhibitory activity. The COMET trial was conducted to investigate whether these properties would lead to better outcomes with carvedilol compared with metoprolol tartrate, a beta-1-selective beta blocker, in more than 3000 heart-failure patients, and the primary results, published in 2003, did indeed show improved rates of survival and cardiovascular hospitalizations in patients receiving carvedilol. But the results have been challenged by some other heart-failure experts, who have pointed out that metoprolol was not given at the optimum dose or formulation in COMET and that the better effect of carvedilol could have been caused simply by a greater effect on beta-1 blockade alone, which could be seen with optimum doses of any beta blocker.
The current analysis was conducted to investigate whether vascular protection could have contributed to the superior effect of carvedilol in the COMET trial and therefore focused on the vascular end points of cardiovascular death, stroke, stroke death, MI, and unstable angina. Results showed a consistently greater effect on these events with carvedilol than with metoprolol.
# posted by roodbont @ 3:09 AM 
