Impact of concurrent amiodarone treatment on the tolerability and efficacy of carvedilol in patients with chronic heart failure
P S Macdonald, A M Keogh, C Aboyoun, M Lund, R Amor, D McCaffrey
Heart
Failure and Transplant Unit, St Vincent's Hospital, Darlinghurst,
Sydney, New South Wales 2010, Australia
Correspondence to: Professor Macdonald. email: pmacdonald{at}stvincents.com.au
Accepted for publication 8 June 1999
OBJECTIVE
To assess
the safety and efficacy of carvedilol when administered to heart
failure patients already receiving amiodarone.
DESIGNRetrospective
analysis of the clinical outcome of 230 patients treated with
carvedilol for chronic heart failure, stratified according to whether
they were already receiving amiodarone (amiodarone group, 80 patients)
or not (non-amiodarone group, 130 patients) at baseline.
SETTINGHeart failure
clinic at a university affiliated public teaching hospital.
MAIN OUTCOME
MEASURESIncidence of adverse events; changes in
functional status and echocardiographic dimensions at three months.
RESULTSAdverse
reactions to carvedilol occurred in 33 (41%) of the amiodarone group
and 43 (29%) of the non-amiodarone group (p = 0.049). Carvedilol was
discontinued in 21 (26%) of the amiodarone group and 37 (25%) of the
non-amiodarone group (NS). The clinical outcome at three months did not
differ significantly between the two groups; 31 (39%) of the
amiodarone group improved their New York Heart Association status, 28 (35%) were unchanged, and 21 (26%) deteriorated compared with 67 (45%), 51 (34%), and 32 (21%), respectively, for the non-amiodarone
group (NS). Both groups had highly significant decreases in heart rate
and left ventricular end systolic dimension, and a significant increase
in left ventricular ejection fraction after three months of carvedilol
treatment, with no significant differences between the groups.
CONCLUSIONSThe
beneficial effects of carvedilol on left ventricular remodelling,
systolic function, and symptomatic status are not affected by
concurrent treatment with amiodarone. Adverse reactions necessitating cessation of carvedilol are no more frequent in patients receiving amiodarone.
Keywords: carvedilol; amiodarone; heart failure
© 1999 by Heart
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Singh, B. N.
(2005). {beta}-Adrenergic Blockers as Antiarrhythmic and Antifibrillatory Compounds: An Overview. J CARDIOVASC PHARMACOL THER
10: S3-S14
[Abstract] -
Sirak, T. E., Jelic, S., Le Jemtel, T. H.
(2004). Therapeutic update: Non-selective beta- and alpha-adrenergic blockade in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure. J Am Coll Cardiol
44: 497-502
[Abstract] [Full Text] -
Arnold, R H, Kotlyar, E, Hayward, C, Keogh, A M, Macdonald, P S
(2003). Relation between heart rate, heart rhythm, and reverse left ventricular remodelling in response to carvedilol in patients with chronic heart failure: a single centre, observational study. Heart
89: 293-298
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
