Carvedilol as a treatment option for cardiovascular diseases

Česká verzia

Authors: J. Jež; J. Vítovec
Authors place of work: I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně
Published in the journal: Kardiol Rev Int Med 2010, 12(1): 28-31

Summary

At present, beta‑blockers represent the basic and life‑ saving treatment modality used for many diseases of the cardiovascular system, particularly for hypertension, ischemic heart disease, heart rhythm disorders and heart failure. Many of them had been a subject to clinical testing that has proven not just their effi cacy but also their safety. Carvedilol is one of the clinically tested and frequently used beta‑blockers, particularly in the treatment of chronic heart failure. This is a non‑selective beta‑blocker with vasodilatatory effects. The paper describes its pharmacological and clinical effects in the treatment of cardiovascular diseases.

Key words:
carvedilol – beta‑blockers – heart failure – hypertension – IHD – arrhythmias

Zdroje

1. Bristow MR, Gilbert EM, Abraham WT et al. Carvedilol produces dose‑related improvements in left ventricular function and survival in subjects with chronic heart failure. Circulation 1996; 94: 2807– 2816.

2. Packer M, Colucci WS, Sackner‑ Bernstein JD et al. Double‑blind, placebo‑ controlled study of the effects of carvedilol in patients with moderate to severe heart failure. The PRECISE trial. Prospective Randomized Evaluation of Carvedilol on Symptoms and Exercise. Circulation 1996; 94: 2793– 2799.

3. Colucci WS, Packer M, Bristow MR et al. Carvedilol inhibits clinical progression in patients with mild symptoms of heart failure. US Carvedilol Heart Failure Study Group. Circulation 1996; 94: 2800– 2806.

4. Cohn JN, Fowler MB, Bristow MR et al. Safety and efficacy of carvedilol in severe heart failure. The U.S. Carvedilol Heart Failure Study Group. J Card Fail 1997; 3: 173– 179.

5. Australia/ New Zealand Heart Failure Research Collaborative Group. Randomised, placebo‑ controlled trial of carvedilol in patients with congestive heart failure due to ischaemic heart disease. Lancet 1997; 349: 375– 380.

6. Vítovec J, Špinar J. Farmakoterapie kardiovaskulárních onemocnění. 2. vyd. Praha: Grada 2004.

7. Morgan T. Clinical pharmacokinetics and pharmacodynamics of carvedilol. Clin Pharmacokinet 1994; 26: 335– 346.

8. Dunn CJ, Lea AP, Wagstaff AJ. Carvedilol: a reappraisal of its pharmacological properties and therapeutic use in cardiovascular disorders. Drugs 1997; 54: 161– 185.

9. Louis WJ, McNeil JJ, Workman BS et al. A pharmacokinetic study of carvedilol (BM 14.190) in elderly subjects: preliminary report. J Cardiovasc Pharmacol 1987; 10: S89– S93.

10. Neugebauer G, Akpan W, von Mollendorff E et al. Pharmacokinetics and disposition of carvedilol in humans. J Cardiovasc Pharmacol 1987; 10: S85– S88.

11. Zhou HH, Wood AJ. Stereoselective disposition of carvedilol is determined by CYP2D6. Clin Pharmacol Ther 1995; 57: 518– 524.

12. Frishman WH. Carvedilol. N Eng J Med 1998; 339: 1759– 1765.

13. Hall S, Prescott RI, Hallman RJ et al. A comparative study of carvedilol, slow‑ release nifedipine, and atenolol in the management of essential hypertension. J Cardiovasc Pharmacol 1991; 18: S35– S38.

14. van der Does R, Eberhardt R, Derr I et al. Treatment of chronic stable angina with carvedilol in comparison with nifedipine s.r. Eur Heart J 1991; 12: 60– 64.

15. Freedman SB, Jamal SM, Harris PJ et al. Comparison of carvedilol and atenolol for angina pectoris. Am J Cardiol 1987; 60: 499– 502.

16. Basu S, Senior R, Raval U et al. Beneficial effects of intravenous and oral carvedilol treatment in acute myocardial infarction: a placebo‑ controlled, randomized trial. Circulation 1997; 96: 183– 191.

17. The CAPRICORN Investigators. Effect of carvedilol on outcome after myocardial infarction in patients with left‑ ventricular dysfunction: the CAPRICORN randomised trial. Lancet 2001; 357: 1385– 1390.

18. Frishman WH, Charlap S. Alpha‑ and beta‑adrenergic blocking drugs. In: Frishman WH, Sonnenblick EH (eds). Cardiovascular pharmacotherapeutics. New York: McGraw‑ Hill 1997: 59– 94.

19. Packer M, Lee WH, Kessler PD et al. Role of neurohormonal mechanisms in determining survival in patiens with severe chronic heart failure. Circulation 1987; 75: IV80– IV92.

20. Sackner‑ Bernstein JD, Mancini DM. Rationale for treatment of patiens with chronic heart failure with adrenergic blockade. JAMA 1995; 274: 1462– 7 (Erratum. JAMA 1996; 275: 686).

21. Waagstein F, Hjalmarson A, Varnauskas E et al. Effect of chronic beta‑adrenergic receptor blockade in congestive cardiomyopathy. Br Heart J 1975; 37: 1022– 1036.

22. Viquerat CE, Daly P, Swedberg K et al. Endogenous catecholamine levels in chronic heart failure: relation to the severity of hemodynamic abnormalities. Am J Med 1985; 78: 455– 460.

23. Henderson EB, Kahn JK, Corbett JR et al. Abnormal I‑ 123 metaiodobenzylguanidine myocardial washout and distribution may reflect myocardial adrenergic derangement in patients with congestive cardiomyopathy. Circulation 1988; 78: 1192– 1199.

24. Zimmer HG, Kolbeck‑ Ruhmkoff C, Zierhut W. Cardiac hypertrophy induced by alpha‑ and beta‑adrenergic receptor stimulation. Cardioscience 1995; 6: 47– 57.

25. Podrid PJ, Fuchs T, Candinas R. Role of the sympathetic nervous system in the genesis of ventricular arrhythmia. Circulation 1990; 82: I103– I113.

26. Packer M, Bristow MR, Cohn JN et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 1996; 334: 1349– 1355.

27. Roden DM. Cardiovascular and Renal Advisory Panel of the US Food and Drug Administration considers four drugs. Circulation 1997; 95: 2335.

28. BEST Trial Investigators. A trial of beta‑blocker bucindolol in patients with advanced chronic heart failure. N Engl J Med 2001; 344: 1659– 1667.

29. Poole‑ Wilson PA, Swedberg K, Cleland JGF et al. Carvedilol Or Metoprolol European Trial Investigators. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol Or Metoprolol European Trial (COMET): randomised controlled trial. Lancet 2003; 362: 7– 13.

30. Wolert KC, Drexler H. Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) Trial: Carvedilol as the Sun and Center of the b‑ Blocker World? Circulation 2002; 106: 2164– 2166.

31. Packer M, Coats AJ, Fowler MB et al. Effect of Carvedilol on Survival in Severe Chronic Heart Failure. N Engl J Med 2001; 344: 1651– 1658.

32. Vítovec J, Špinar J. Který betablokátor u srdečního selhání? Studie COMET – dala jasnou odpověď? Cor Vasa 2003; 45: 527– 528.

33. Hjalmarson A, Kneider M, Waagstein F. The role of beta‑blockers in left ventricular dysfunction and heart failure. Drugs 1997; 54: 501– 510.

34. The Beta‑Blocker Pooling Project Research Group. The Beta‑Blocker Pooling Project (BBPP): subgroup findings from randomized trials in post infarction patients. Eur Heart J 1988; 9: 8– 16.

35. Olivetti G, Abbi R, Quaini F et al. Apoptosis in the failing human heart. N Engl J Med 1997; 336: 1131– 1141.

36. Yancy C, Fowler MB, Colucci WS et al. Response of black heart failure patients to carvedilol. J Am Coll Cardiol 1997; 29: 284A abstract.