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Carvedilol vs. Metoprolol Effectiveness in Patients With Left Ventricular Assist Devices: A TriNetX Analysis
Karldon I Nwaezeapu1, Godbless Ajenaghughrure2, Ekow Essien3
1Internal Medicine, Trinity Health Ann Arbor Hospital, Ypsilanti, USA.
Cureus
|August 11, 2025
Summary
Carvedilol use in left ventricular assist device (LVAD) patients was linked to lower mortality and fewer cardiac events than metoprolol. However, carvedilol also showed increased heart failure exacerbation and kidney issues, requiring careful patient selection.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Beta-blockers are crucial for heart failure management.
- Comparative data on beta-blockers in mechanical circulatory support patients are limited.
- This study compares carvedilol and metoprolol in left ventricular assist device (LVAD) patients.
Purpose of the Study:
- To compare clinical outcomes between carvedilol and metoprolol in LVAD patients.
- To evaluate the effectiveness of carvedilol versus metoprolol in reducing mortality and adverse events.
- To inform beta-blocker selection in LVAD recipients.
Main Methods:
- Retrospective cohort study using the TriNetX Research Network.
- Propensity score matching of 5,166 patients each on carvedilol or metoprolol.
- Analysis of all-cause mortality and secondary outcomes over one year.
Main Results:
- Carvedilol group had lower all-cause mortality (15.4% vs. 17.0%) and reduced cardiac arrest, cardiogenic shock, sepsis, and atrial fibrillation.
- Higher rates of heart failure exacerbation (71.3% vs. 65.9%) and acute kidney injury (31.8% vs. 28.1%) were observed with carvedilol.
- No significant difference in sick sinus syndrome; ventricular tachycardia rates were not clinically significant.
Conclusions:
- Carvedilol is associated with lower mortality and fewer cardiovascular complications than metoprolol in LVAD patients.
- Higher rates of heart failure exacerbation and renal complications necessitate individualized patient selection.
- Further prospective studies are needed to confirm findings and optimize beta-blocker choice.
Keywords:
advanced heart failurebeta blockerscarvedilolheart failureleft ventricular assist device (lvad)lvadmechanical circulatory supportmetoprololmortalityMore Related Videos
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