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Comparative effects of carvedilol vs bisoprolol for severe congestive heart failure

Masanori Konishi1, Go Haraguchi, Shigeki Kimura

  • 1Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.

Circulation Journal : Official Journal of the Japanese Circulation Society
|April 1, 2010
PubMed

Insights

Carvedilol and bisoprolol equally improve severe heart failure (HF). However, bisoprolol demonstrates better outcomes for patients with atrial fibrillation (AF), including heart rate control and rhythm restoration.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Carvedilol and bisoprolol are established treatments for heart failure (HF).
  • Limited comparative data exists for their efficacy in severe HF patients.
  • This study addresses the need for comparative analysis in this population.

Purpose of the Study:

  • To compare the clinical effects of carvedilol and bisoprolol in patients with severe heart failure.
  • To evaluate differences in outcomes, particularly in patients with co-existing atrial fibrillation (AF).

Main Methods:

  • Retrospective analysis of 655 heart failure patients (NYHA Class 3-4).
  • 217 patients receiving carvedilol (n=110) or bisoprolol (n=107) were analyzed.
  • 18-month follow-up period assessing survival and cardiac events.

Main Results:

  • No significant differences in survival or cardiac event-free rates between carvedilol and bisoprolol for overall severe HF.
  • In patients with atrial fibrillation (AF), bisoprolol showed significant improvements in heart rate and brain natriuretic peptide levels compared to carvedilol.
  • Bisoprolol led to a higher rate of defibrillation from AF to sinus rhythm (48% vs. 16%).

Conclusions:

  • Carvedilol and bisoprolol exhibit comparable efficacy in improving severe heart failure.
  • Bisoprolol demonstrates superior benefits for heart failure patients also suffering from atrial fibrillation.
  • Bisoprolol may be a preferred choice for managing severe HF with AF.
Abstract

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