Sökning: WFRF:(Di Lenarda A) >
Exchange of beta-bl...
Exchange of beta-blockers in heart failure patients. Experiences from the poststudy phase of COMET (the Carvedilol or Metoprolol European Trial)
-
Di Lenarda, A. (författare)
-
Remme, W. J. (författare)
-
Charlesworth, A. (författare)
-
visa fler...
-
Cleland, J. G. (författare)
-
Lutiger, B. (författare)
-
Metra, M. (författare)
-
Komajda, M. (författare)
-
Torp-Pedersen, C. (författare)
-
Scherhag, A. (författare)
-
- Swedberg, Karl, 1944 (författare)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
-
Poole-Wilson, P. A. (författare)
-
visa färre...
-
(creator_code:org_t)
- 2005-05-28
- 2005
- Engelska.
-
Ingår i: European journal of heart failure. - : Wiley. - 1388-9842. ; 7:4, s. 640-9
- Relaterad länk:
-
https://onlinelibrar...
-
visa fler...
-
https://gup.ub.gu.se...
-
https://doi.org/10.1...
-
visa färre...
Abstract
Ämnesord
Stäng
- BACKGROUND: The Carvedilol or Metoprolol European Trial (COMET) reported a significant survival benefit for carvedilol, a beta1-, beta2- and alpha1-blocker, vs. metoprolol tartrate, a beta1-selective blocker, in patients with mild-to-severe chronic heart failure (CHF). Patients on treatment with metoprolol might benefit from switching to carvedilol. AIM: To investigate the safety and tolerability of switching beta-blockers in CHF. METHODS: At the end of COMET, the Steering Committee recommended that study medication was stopped without unblinding, and patients were commenced on open-label beta-blockade at a dose equivalent to half the dose of blinded therapy, with subsequent titration to target or maximum tolerated dose. Patients were followed for 30 days. RESULTS: 1321 out of 1440 patients were transitioned to open-label treatment (76.8% to carvedilol). Serious adverse and CHF-related events were respectively 9.4% and 4.7% in those switching from carvedilol to metoprolol and 3.1% and 1.5% in patients switching from metoprolol to carvedilol. Patients who switched from carvedilol to metoprolol showed the highest mortality or hospitalisation rate (12.3%) in comparison with those who switched from metoprolol to carvedilol (3.1%, p<0.001) or who stayed on the same drug (carvedilol: 2.5%, p<0.001; metoprolol: 4.2%, p=0.04). Reducing the initial dose of the second beta-blocker maximised the safety of this strategy. Event rate was higher in patients with more severe heart failure and in those withdrawing from beta-blockade. CONCLUSION: Our data show that switching beta-blockers is a practical, safe and well-tolerated strategy to optimise treatment of CHF. Patients who switched to carvedilol showed the lowest rate of adverse events. A closer clinical monitoring is recommended during transition in high-risk patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- dosage/pharmacology/*therapeutic use
- Aged
- Blood Pressure/drug effects
- Carbazoles/administration & dosage/pharmacology/*therapeutic use
- Female
- Heart Failure
- Congestive/*drug therapy
- Heart Rate/drug effects
- Humans
- Male
- Metoprolol/administration & dosage/pharmacology/*therapeutic use
- Middle Aged
- Propanolamines/administration & dosage/pharmacology/*therapeutic use
- Randomized Controlled Trials
- Treatment Outcome
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
-
Di Lenarda, A.
-
Remme, W. J.
-
Charlesworth, A.
-
Cleland, J. G.
-
Lutiger, B.
-
Metra, M.
-
visa fler...
-
Komajda, M.
-
Torp-Pedersen, C ...
-
Scherhag, A.
-
Swedberg, Karl, ...
-
Poole-Wilson, P. ...
-
visa färre...
- Om ämnet
-
- MEDICIN OCH HÄLSOVETENSKAP
-
MEDICIN OCH HÄLS ...
-
och Klinisk medicin
-
och Kardiologi
- Artiklar i publikationen
-
European journal ...
- Av lärosätet
-
Göteborgs universitet