Beneficial effects of carvedilol as a concomitant therapy to angiotensin-converting enzyme inhibitor in patients with ischemic left ventricular systolic dysfunction.
Studies are scant on the effects of short-term carvedilol treatment as an adjuvant to angiotensin-converting enzyme (ACE) inhibitor in patients with left ventricular (LV) systolic dysfunction. The objective of this study was to find the effects of short-term treatment of carvedilol on patients with ischemic LV systolic dysfunction (defined as LV ejection fraction (LVEF) <or=30% on 2D echocardiography) undergoing coronary artery bypass surgery (CABG). There were 74 patients that received ACE inhibitor without any beta-blocker (control) and 67 patients that received carvedilol in addition to ACE inhibitor following CABG (carvedilol group). After 1 month of drug administration following CABG, the control group was found to have significantly greater percent improvement in LVEF (29.1% +/- 5.39%) as compared with the carvedilol group (15.3% +/- 4.89%). However, after 3 and 6 months, LVEF levels were found to be significantly greater in the carvedilol group as compared with the control group. Further, at 6 months of drug administration, LV end systolic diameter was significantly less in the carvedilol group (39.11 +/- 1.10 mm) as compared with the control group (43.49 +/- 1.39 mm). Thus, carvedilol produces beneficial effect on short-term administration in terms of LV contractility when given along with ACE inhibitor as compared with ACE inhibitor therapy alone.
Gandhi
Purvi S
PS
Department of Pharmacology, L. M. College of Pharmacy, P.O. Box 4011, Navrangpura, Ahmedabad-380009 Gujarat, India.
Goyal
Ramesh K
RK
Jain
Anil R
AR
Mallya
B Srinivas
BS
Gupta
Vishal M
VM
Shah
Dhiren S
DS
Trivedi
Bharat R
BR
Shastri
Naman A
NA
Mehta
Chirag B
CB
Jain
Kalpana A
KA
Bhavasar
Niren S
NS
Shah
Urmi J
UJ
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D002227:Carbazoles / Q000008:administration & dosage*; D000077261:Carvedilol; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D018384:Oxidative Stress; D011412:Propanolamines / Q000008:administration & dosage*; D011446:Prospective Studies; D013318:Stroke Volume / Q000187:drug effects; D013599:Systole / Q000187:drug effects*; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol