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Comparison of the Use of Carvedilol Versus Nebivolol in the Treatment of Acute Decompensation in the Patient with Chronic Heart Failure: Evaluation of Clinical Variables

Received: 9 December 2022     Accepted: 17 January 2023     Published: 31 May 2023
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Abstract

Previous trials demonstrated the safety of using beta-blockers in the acute decompensation of heart failure; it is unknown whether the use of nebivolol translates into an improvement in clinical parameters at 96 hours, compared to the use of carvedilol in a similar study group. Objectives: To compare the effect of 2 treatment strategies, where the difference is made by the type of beta-blocker, in patients with acutely decompensated chronic heart failure. Methods: A single-center, prospective, experimental, randomized, double-blind clinical trial was carried out, 22 patients with LVEF ≤ 40% were randomly assigned to receive carvedilol or nebivolol with daily dose increase, clinical variables were measured for 96 hours. Results: The carvedilol group reached a maximum dose of 33.3 ± 10 mg and nebivolol 9.37 ± 1.25 mg, with both treatment strategies compensation was achieved in more than 50% of the patients in both groups, without statistically significant differences for the majority of patients. clinical variables, except for greater weight loss in the carvedilol group, reaching an absolute reduction of 5.62 kg (95% CI 3.22-8.02 kg) versus nebivolol with 2.54 kg (95% CI 0. 14-4.94 kg) at 96 hours of follow-up (p 0.001) Conclusions: In patients with acutely decompensated chronic heart failure and reduced LVEF, the use of beta-blockers is safe and well tolerated, guarantees clinical improvement and rapid compensation, with doses diuretic drops. The group with carvedilol showed greater weight reduction, compared to the nebivolol group in the study population.

Published in American Journal of Internal Medicine (Volume 11, Issue 3)
DOI 10.11648/j.ajim.20231103.14
Page(s) 48-54
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Beta-Blockers, Diuretics, Acutely Decompensated Heart Failure

References
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[14] Cullington D, Goode K, Clark A, John G. Cleland Heart rate achieved or beta-blocker dose in patients with chronic heart failure: which is the better target? European Journal of Heart Failure (2012) 14, 737–747.
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Cite This Article
  • APA Style

    Francisco Jose Sánchez Rivas, Jorge Luis García, Gabriela Guanay, José Hipolito Donis Hernandez. (2023). Comparison of the Use of Carvedilol Versus Nebivolol in the Treatment of Acute Decompensation in the Patient with Chronic Heart Failure: Evaluation of Clinical Variables. American Journal of Internal Medicine, 11(3), 48-54. https://doi.org/10.11648/j.ajim.20231103.14

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    ACS Style

    Francisco Jose Sánchez Rivas; Jorge Luis García; Gabriela Guanay; José Hipolito Donis Hernandez. Comparison of the Use of Carvedilol Versus Nebivolol in the Treatment of Acute Decompensation in the Patient with Chronic Heart Failure: Evaluation of Clinical Variables. Am. J. Intern. Med. 2023, 11(3), 48-54. doi: 10.11648/j.ajim.20231103.14

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    AMA Style

    Francisco Jose Sánchez Rivas, Jorge Luis García, Gabriela Guanay, José Hipolito Donis Hernandez. Comparison of the Use of Carvedilol Versus Nebivolol in the Treatment of Acute Decompensation in the Patient with Chronic Heart Failure: Evaluation of Clinical Variables. Am J Intern Med. 2023;11(3):48-54. doi: 10.11648/j.ajim.20231103.14

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  • @article{10.11648/j.ajim.20231103.14,
      author = {Francisco Jose Sánchez Rivas and Jorge Luis García and Gabriela Guanay and José Hipolito Donis Hernandez},
      title = {Comparison of the Use of Carvedilol Versus Nebivolol in the Treatment of Acute Decompensation in the Patient with Chronic Heart Failure: Evaluation of Clinical Variables},
      journal = {American Journal of Internal Medicine},
      volume = {11},
      number = {3},
      pages = {48-54},
      doi = {10.11648/j.ajim.20231103.14},
      url = {https://doi.org/10.11648/j.ajim.20231103.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20231103.14},
      abstract = {Previous trials demonstrated the safety of using beta-blockers in the acute decompensation of heart failure; it is unknown whether the use of nebivolol translates into an improvement in clinical parameters at 96 hours, compared to the use of carvedilol in a similar study group. Objectives: To compare the effect of 2 treatment strategies, where the difference is made by the type of beta-blocker, in patients with acutely decompensated chronic heart failure. Methods: A single-center, prospective, experimental, randomized, double-blind clinical trial was carried out, 22 patients with LVEF ≤ 40% were randomly assigned to receive carvedilol or nebivolol with daily dose increase, clinical variables were measured for 96 hours. Results: The carvedilol group reached a maximum dose of 33.3 ± 10 mg and nebivolol 9.37 ± 1.25 mg, with both treatment strategies compensation was achieved in more than 50% of the patients in both groups, without statistically significant differences for the majority of patients. clinical variables, except for greater weight loss in the carvedilol group, reaching an absolute reduction of 5.62 kg (95% CI 3.22-8.02 kg) versus nebivolol with 2.54 kg (95% CI 0. 14-4.94 kg) at 96 hours of follow-up (p 0.001) Conclusions: In patients with acutely decompensated chronic heart failure and reduced LVEF, the use of beta-blockers is safe and well tolerated, guarantees clinical improvement and rapid compensation, with doses diuretic drops. The group with carvedilol showed greater weight reduction, compared to the nebivolol group in the study population.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Comparison of the Use of Carvedilol Versus Nebivolol in the Treatment of Acute Decompensation in the Patient with Chronic Heart Failure: Evaluation of Clinical Variables
    AU  - Francisco Jose Sánchez Rivas
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    AU  - José Hipolito Donis Hernandez
    Y1  - 2023/05/31
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ajim.20231103.14
    DO  - 10.11648/j.ajim.20231103.14
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    EP  - 54
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20231103.14
    AB  - Previous trials demonstrated the safety of using beta-blockers in the acute decompensation of heart failure; it is unknown whether the use of nebivolol translates into an improvement in clinical parameters at 96 hours, compared to the use of carvedilol in a similar study group. Objectives: To compare the effect of 2 treatment strategies, where the difference is made by the type of beta-blocker, in patients with acutely decompensated chronic heart failure. Methods: A single-center, prospective, experimental, randomized, double-blind clinical trial was carried out, 22 patients with LVEF ≤ 40% were randomly assigned to receive carvedilol or nebivolol with daily dose increase, clinical variables were measured for 96 hours. Results: The carvedilol group reached a maximum dose of 33.3 ± 10 mg and nebivolol 9.37 ± 1.25 mg, with both treatment strategies compensation was achieved in more than 50% of the patients in both groups, without statistically significant differences for the majority of patients. clinical variables, except for greater weight loss in the carvedilol group, reaching an absolute reduction of 5.62 kg (95% CI 3.22-8.02 kg) versus nebivolol with 2.54 kg (95% CI 0. 14-4.94 kg) at 96 hours of follow-up (p 0.001) Conclusions: In patients with acutely decompensated chronic heart failure and reduced LVEF, the use of beta-blockers is safe and well tolerated, guarantees clinical improvement and rapid compensation, with doses diuretic drops. The group with carvedilol showed greater weight reduction, compared to the nebivolol group in the study population.
    VL  - 11
    IS  - 3
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Author Information
  • Department of Medicine, Cardiovascular Investigation Institute, The Andes University Hospital, The Andes University, Mérida, Venezuela

  • Department of Medicine, Cardiovascular Investigation Institute, The Andes University Hospital, The Andes University, Mérida, Venezuela

  • Department of Medicine, Cardiovascular Investigation Institute, The Andes University Hospital, The Andes University, Mérida, Venezuela

  • Cardiovascular Institute, The Andes University, Mérida, Venezuela

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