Antiarrythmic effect of carvedilol after acute myocardial infarction

McMurray, J. , Kober, L., Robertson, M., Dargie, H., Colucci, W., Lopez-Sendon, J., Remme, W., Sharpe, N. and Ford, I. (2005) Antiarrythmic effect of carvedilol after acute myocardial infarction. Journal of the American College of Cardiology, 45(4), pp. 525-530. (doi:10.1016/j.jacc.2004.09.076)

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Abstract

OBJECTIVES: Whether beta-blockers reduce atrial arrhythmias and, when added to an angiotensin-converting enzyme (ACE) inhibitor, ventricular arrhythmia is unknown.

BACKGROUND: Ventricular and atrial arrhythmias are common after acute myocardial infarction (AMI) and are associated with a poor prognosis. Angiotensin-converting enzyme inhibitors reduce the incidence of both types of arrhythmia.

METHODS: The antiarrhythmic effect of carvedilol was examined in a placebo-controlled multicenter trial, the Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN) study, which enrolled 1,959 patients with reduced left ventricular systolic function after AMI, 98% of whom were treated with an ACE inhibitor.

RESULTS: The incidence of atrial fibrillation/flutter was 53 to 984 (5.4%) in the placebo group and 22 to 975 (2.3%) in the carvedilol group, giving a carvedilol/placebo hazard ratio (HR) of 0.41 (95% confidence interval [CI] 0.25 to 0.68; p = 0.0003). The corresponding rates of ventricular tachycardia/flutter/fibrillation were 38 to 984 (3.9%) and 9 to 975 (0.9%) (HR 0.24, 95% CI 0.11 to 0.49; p < 0.0001).

CONCLUSIONS: Carvedilol has a powerful antiarrhythmic effect after AMI, even in patients already treated with an ACE inhibitor. Carvedilol suppresses atrial as well as ventricular arrhythmias in these patients.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Robertson, Mrs Michele and Ford, Professor Ian and McMurray, Professor John and Dargie, Professor Henry
Authors: McMurray, J., Kober, L., Robertson, M., Dargie, H., Colucci, W., Lopez-Sendon, J., Remme, W., Sharpe, N., and Ford, I.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
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Journal Name:Journal of the American College of Cardiology
Journal Abbr.:J. Am. Coll. Cardiol.
Publisher:Elsevier Inc.
ISSN:0735-1097
ISSN (Online):1558-3597
Published Online:15 February 2005

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