Nonselective versus selective beta-blockers in the management of chronic heart failure: clinical implications of the carvedilol or Metoprolol European Trial.
The abundance of evidence supporting beta-blocker therapy has resulted in the widespread acceptance of these drugs in the treatment of heart-failure patients. However, beta-blockers are not a homogeneous class of drugs, and important differences in efficacy have been noted between different members of the class. Thus, practicing physicians are faced with a choice when selecting a particular beta-blocker for treating heart failure. One of the considerations is whether to choose a selective or a nonselective beta-blocker. The results of the Carvedilol or Metoprolol European Trial indicate that carvedilol, a third-generation, nonselective beta-blocker with additional a-blocking, antioxidant, and other properties, is clearly superior to a beta1-blocking drug, metoprolol tartrate. The choice between these drugs is therefore unambiguously in favor of carvedilol.
Greenberg
Barry
B
Heart Failure/Cardiac Transplantation Program, University of California, San Diego, San Diego, California, USA.
D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008790:Metoprolol / Q000494:pharmacology / Q000627:therapeutic use*
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D008790:Metoprolol