title: Meta-analysis of the effects of carvedilol versus metoprolol on all-cause mortality and hospitalizations in patients with heart failure.
abstract: Long-term treatment with appropriate doses of carvedilol or metoprolol is currently recommended for patients with heart failure with reduced ejection fraction (HFrEF) to decrease the risk of death, hospitalizations, and patients' symptoms. It remains unclear if the β blockers used in patients with HFrEF are equal or carvedilol is superior to metoprolol types. We performed a meta-analysis of the comparative effects of carvedilol versus metoprolol tartrate and succinate on all-cause mortality and/or hospitalization. We conducted an Embase and MEDLINE search for prospective controlled trials and cohort studies of patients with HFrEF who were received to treatment with carvedilol versus metoprolol. We identified 4 prospective controlled and 6 cohort studies with 30,943 patients who received carvedilol and 69,925 patients on metoprolol types (tartrate and succinate) with an average follow-up duration of 36.4 months. All-cause mortality was reduced in prospective studies with carvedilol versus metoprolol tartrate. Neither all-cause mortality nor hospitalizations were significantly different between carvedilol and metoprolol succinate in the cohort studies. In conclusion, in patients with HFrEF, carvedilol and metoprolol succinate have similar effects in reducing all-cause mortality.
authors.affiliation: Department of Cardiology, Detroit Medical Center, Wayne State University, Detroit, Michigan. Electronic address: alexbriasoulis@gmail.com.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Briasoulis
authors.affiliation: Department of Cardiology, Detroit Medical Center, Wayne State University, Detroit, Michigan.
authors.forename: Mohan
authors.initials: M
authors.lastname: Palla
authors.affiliation: Department of Cardiology, Detroit Medical Center, Wayne State University, Detroit, Michigan.
authors.forename: Luis
authors.initials: L
authors.lastname: Afonso
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D002423:Cause of Death / Q000639:trends; D014943:Global Health; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008790:Metoprolol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015995:Prevalence; D011379:Prognosis; D011412:Propanolamines / Q000627:therapeutic use*; D015996:Survival Rate / Q000639:trends
chemical_list: D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D008790:Metoprolol