Meta-Analysis of the Effects of Carvedilol Versus Metoprolol on All-Cause Mortality and Hospitalizations in Patients With Heart Failure
Meta-Analysis of the Effects of Carvedilol Versus Metoprolol on All-Cause Mortality and Hospitalizations in Patients With Heart Failure
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DOI：
10.1016/j.amjcard.2015.01.545
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发表时间：
2015-04-15
影响因子：
2.8
通讯作者：
Afonso, Luis
中科院分区：
文献类型：
--
作者：
Briasoulis, Alexandros;Palla, Mohan;Afonso, Luis
目前建议对射血分数降低的心力衰竭 (HFrEF) 患者进行适当剂量的卡维地洛或美托洛尔长期治疗，以降低死亡、住院和患者症状的风险。目前尚不清楚 HFrEF 患者使用的 β 受体阻滞剂是否相同或卡维地洛优于美托洛尔类型。我们对卡维地洛与酒石酸美托洛尔和琥珀酸盐对全因死亡率和/或住院治疗的影响进行了荟萃分析。我们对接受卡维地洛与美托洛尔治疗的 HFrEF 患者进行了 Embase 和 MEDLINE 检索，进行了前瞻性对照试验和队列研究。我们确定了 4 项前瞻性对照研究和 6 项队列研究，涉及 30,943 名接受卡维地洛治疗的患者和 69,925 名接受美托洛尔类型（酒石酸盐和琥珀酸盐）治疗的患者，平均随访时间为 36.4 个月。在前瞻性研究中，卡维地洛与酒石酸美托洛尔相比，全因死亡率降低。在队列研究中，卡维地洛和琥珀酸美托洛尔之间的全因死亡率和住院率均无显着差异。总之，对于 HFrEF 患者，卡维地洛和琥珀酸美托洛尔在降低全因死亡率方面具有相似的效果。 (C) 2015 Elsevier Inc. 保留所有权利。
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 beta 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. (C) 2015 Elsevier Inc. All rights reserved.