© 2003 European Society of Cardiology
Efficacy and tolerability of the long-term administration of carvedilol in patients with chronic heart failure with and without concomitant diabetes mellitus
a Cattedra di Cardiologia, Università di Brescia Piazza Spedali Civili, 25100 Brescia, Italy
b Istituto di Clinica Medica Università di Parma, Italy
* Corresponding author. Tel.: +39-030-307221; fax: +39-030-3700359 E-mail address: metramarco{at}libero.it
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Abstract |
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Background: Diabetes is frequently associated with heart failure and is an independent risk factor for an increased mortality and morbidity. Beta-blockers are traditionally regarded as relatively contraindicated in patients with diabetes mellitus.
Aim of the study: To assess the efficacy and tolerability of carvedilol administration in patients with heart failure and concomitant diabetes.
Methods and results: One hundred ninety-three patients (68 diabetics, 125 non-diabetics) with chronic heart failure were assessed by radionuclide ventriculography, cardiopulmonary exercise testing and right heart catheterization before and after 12 months of maintenance carvedilol treatment (mean dose, 40±19 mg daily). Diabetic patients were older and with a lower peak VO2, compared with non-diabetics. Long-term carvedilol administration was associated with an improvement in left ventricular function, clinical symptoms, resting and exercise hemodynamic parameters compared to baseline, with no significant difference between the diabetic and the non-diabetic patients. The incidence of adverse effects was also similar between the two groups. Diabetics had higher all-cause mortality with a similar mortality and hospitalization rate, compared to non-diabetics during 33±20 months of follow-up.
Conclusion: Concomitant diabetes does not influence the efficacy and tolerability of carvedilol administration in patients with chronic heart failure.
Key Words: Carvedilol • Chronic heart failure • Concomitant diabetes
Received September 2, 2002; Revised April 28, 2003; Accepted July 17, 2003
This paper was partially supported by CARIPLO funds from ‘Centro per lo studio del trattamento dello scompenso cardiaco’ of the University of Brescia.
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