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Long-term use of carvedilol in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention
| Content Provider | Semantic Scholar |
|---|---|
| Author | Watanabe, Hiroki Ozasa, Neiko Morimoto, Tatsuya Shiomi, Hiroki Bingyuan, Bao Suwa, Satoru Nakagawa, Yukinobu Izumi, Chisato Kadota, Kazushige Ikeguchi, Shigeru Hibi, Kiyoshi Furukawa, Yotsukazu Kaji, S. Mohammadi Suzuki, Takahiko Akao, Masaharu Inada, Tsukasa Hayashi, Yasuhito Nanasato, Mamoru Okutsu, Masaaki Kametani, Ryosuke Sone, Takahito Sugimura, Yusuke Kawai, Kazuya Abe, Mitsunori Kaneko, Hironori Nakamura, Sunao Kimura, Takeshi |
| Copyright Year | 2018 |
| Abstract | BACKGROUND Despite its recommendation by the current guidelines, the role of long-term oral beta-blocker therapy has never been evaluated by randomized trials in uncomplicated ST-segment elevation myocardial infarction (STEMI) patients without heart failure, left ventricular dysfunction or ventricular arrhythmia who underwent primary percutaneous coronary intervention (PCI). METHODS AND RESULTS In a multi-center, open-label, randomized controlled trial, STEMI patients with successful primary PCI within 24 hours from the onset and with left ventricular ejection fraction (LVEF) ≥40% were randomly assigned in a 1-to-1 fashion either to the carvedilol group or to the no beta-blocker group within 7 days after primary PCI. The primary endpoint is a composite of all-cause death, myocardial infarction, hospitalization for heart failure, and hospitalization for acute coronary syndrome. Between August 2010 and May 2014, 801 patients were randomly assigned to the carvedilol group (N = 399) or the no beta-blocker group (N = 402) at 67 centers in Japan. The carvedilol dose was up-titrated from 3.4±2.1 mg at baseline to 6.3±4.3 mg at 1-year. During median follow-up of 3.9 years with 96.4% follow-up, the cumulative 3-year incidences of both the primary endpoint and any coronary revascularization were not significantly different between the carvedilol and no beta-blocker groups (6.8% and 7.9%, P = 0.20, and 20.3% and 17.7%, P = 0.65, respectively). There also was no significant difference in LVEF at 1-year between the 2 groups (60.9±8.4% and 59.6±8.8%, P = 0.06). CONCLUSION Long-term carvedilol therapy added on the contemporary evidence-based medications did not seem beneficial in selected STEMI patients treated with primary PCI. TRIAL REGISTRATION CAPITAL-RCT (Carvedilol Post-Intervention Long-Term Administration in Large-scale Randomized Controlled Trial) ClinicalTrials.gov.number, NCT 01155635. |
| Starting Page | 47 |
| Ending Page | 50 |
| Page Count | 4 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 30153268v1 |
| Alternate Webpage(s) | https://doi.org/10.1371/journal.pone.0199347 |
| DOI | 10.1371/journal.pone.0199347 |
| Journal | PloS one |
| Volume Number | 13 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Acute Coronary Syndrome Addison Disease Adrenergic beta-Antagonists Cardiomyopathies Cerebrovascular accident Cessation of life Ejection fraction (procedure) Follow-Up Report Heart failure Hospitalization Left ventricular ejection fraction Numerous Patients Percutaneous Coronary Intervention PersonNameUse - assigned Post-Traumatic Stress Disorder ST segment elevation myocardial infarction Ventricular Dysfunction Ventricular Dysfunction, Left Ventricular arrhythmia carvedilol coronary revascularization |
| Content Type | Text |
| Resource Type | Article |
