Premium
Betablockers in heart failure: Carvedilol Safety Assessment (CASA 2‐trial)
Author(s) -
Rickli Hans,
Steiner Simon,
Müller Karin,
Hess Otto M.
Publication year - 2004
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2003.11.025
Subject(s) - medicine , carvedilol , tolerability , heart failure , adverse effect , cardiology , blood pressure
Background: Betablockers are a cornerstone in the treatment of patients with chronic heart failure (CHF). The purpose of the present study was to assess safety and tolerability of carvedilol in CHF‐patients. Methods: 66 general practitioners, who were supervised by a local cardiologist, enrolled 151 CHF‐patients. All patients were on standard therapy with ACE‐inhibitors and diuretics. Carvedilol treatment was started with 3.125 mg twice daily and slowly uptitrated in 2‐week intervals to 2×25 mg per day. Mean follow‐up was 12 weeks. Results: 145 of the 151 patients (96%) finished the study according to protocol, six patients were lost to follow‐up (4%). 59 patients (41%) experienced minor and nine (6%) serious adverse events. 68 were under maximal therapy with 50 mg daily, 33 received 25 mg, and 15 12.5 mg. Overall tolerability was good and NYHA‐class fell significantly from 2.2 to 1.8 ( P <0.001). Mean heart rate decreased from 78 to 69 bpm ( P <0.001), mean systolic blood pressure from 137 to 132 mmHg ( P <0.001) and mean diastolic blood pressure from 80 to 76 mmHg ( P <0.001). Quality of life significantly improved under carvedilol with a reduction in the Minnesota living with heart failure score from 1.28 to 0.88 ( P <0.001). Conclusions: Carvedilol is well tolerated in CHF‐patients treated by general practitioners. Serious adverse events and hospitalisations are rare. Thus, carvedilol is a safe drug in the treatment of CHF‐patients and can be easily initiated and managed by the general practitioner.