A comparison of the two beta-blockers carvedilol and atenolol on left ventricular ejection fraction and clinical endpoints after myocardial infarction. a single-centre, randomized study of 232 patients.
BACKGROUND
beta-Blockers have been found to reduce mortality and morbidity in postmyocardial infarction patients. However, it is not fully understood whether all beta-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).


CONCLUSIONS
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.
Jonsson
Gisli
G
Department of Cardiology, Ullevaal University Hospital, University of Oslo, Oslo, Norway.
Abdelnoor
Michael
M
Müller
Carl
C
Kjeldsen
Sverre Erik
SE
Os
Ingrid
I
Westheim
Arne
A
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000368:Aged; D001262:Atenolol / Q000494:pharmacology* / Q000627:therapeutic use; D002227:Carbazoles / Q000494:pharmacology* / Q000627:therapeutic use; D000077261:Carvedilol; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D011412:Propanolamines / Q000494:pharmacology* / Q000627:therapeutic use; D013318:Stroke Volume / Q000187:drug effects*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects*
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D001262:Atenolol