A Comparison of the Two β-Blockers Carvedilol and Atenolol on Left Ventricular Ejection Fraction and Clinical Endpoints after Myocardial Infarction
A Single-Centre, Randomized Study of 232 PatientsJonsson G. · Abdelnoor M. · Müller C. · Kjeldsen S.E. · Os I. · Westheim A.
aDepartment of Cardiology, bCenter of Clinical Research, cDepartment of Nuclear Medicine, and dDepartment of Nephrology, Ullevaal University Hospital, University of Oslo, Oslo, Norway
Background: β-Blockers have been found to reduce mortality and morbidity in postmyocardial infarction patients. However, it is not fully understood whether all β-blockers have similar favourable cardiovascular effects. The aim of this study was to compare the effects of carvedilol and atenolol on global and regional left ventricular ejection fraction (LVEF) and on predefined cardiovascular endpoints. Methods: In a single-centre, randomized, open, endpoint-blinded, parallel group study, 232 patients with acute myocardial infarction were randomized to treatment with carvedilol or atenolol. LVEF was measured by gated blood pool scintigraphy during the first week and after 12 months. The treatment was given orally within 24 h. The mean dose was 36.2 and 72.1 mg in the carvedilol and atenolol groups, respectively. Results: No significant difference was found between the two study groups in the mean global and regional LVEF. There tended to be fewer first serious cardiovascular events in the carvedilol compared with the atenolol group (RR = 0.83, 95% CI 0.56–1.23, p = 0.39). Cold hands and feet were observed less frequently in the carvedilol group (20 vs. 33%, p = 0.025). Conclusion: In patients following an acute myocardial infarction, no difference in either global or regional LVEF was observed between baseline and 12 months when treatment with carvedilol was compared with atenolol.
Arne Westheim, MD, PhD
Department of Cardiology, Ullevaal University Hospital
NO–0407 Oslo (Norway)
Tel. +47 22119100, Fax +47 22119181
Received: April 22, 2004
Accepted after revision: August 26, 2004
Published online: March 21, 2005
Number of Print Pages : 8
Number of Figures : 6, Number of Tables : 3, Number of References : 35
Cardiology (International Journal of Cardiovascular Medicine, Surgery and Pathology)
Vol. 103, No. 3, Year 2005 (Cover Date: Released April 2005)
Journal Editor: J.S. Alpert, Tucson, Ariz.
ISSN: 0008–6312 (print), 1421–9751 (Online)
For additional information: http://www.karger.com/crd