Survival among patients with left ventricular systolic dysfunction treated with atenolol.
Metoprolol succinate, carvedilol, and bisoprolol are approved for use in heart failure. Other beta-blockers have been found to be inferior (metoprolol tartrate) or have not been studied (atenolol). The authors compared all-cause mortality following treatment with either atenolol, carvedilol, or metoprolol tartrate for 974 patients with left ventricular function < or =40%. The unadjusted mortality at 6 months was lower with atenolol (3.2%) and carvedilol (4.2%) when compared with metoprolol tartrate (7.5%, P< or =.039). However, patients with atenolol were older but had less prior heart failure. After adjustment for the propensity to be treated with atenolol, patients actually treated with atenolol had a significantly lower risk of death compared with treatment with metoprolol tartrate and comparable outcome to those treated with carvedilol. These results suggest that atenolol may be useful for patients with heart failure treatment and highlight the need for a randomized trial comparing atenolol with established beta-blockers.
Kapoor
John R
JR
Stanford University, Palo Alto, CA, USA. jkapoor@stanford.edu
Heidenreich
Paul A
PA
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use*; D002140:California; D016001:Confidence Intervals; D005260:Female; D006305:Health Status Indicators; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D013318:Stroke Volume / Q000187:drug effects; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality*; D016277:Ventricular Function, Left / Q000187:drug effects
D000959:Antihypertensive Agents; D001262:Atenolol