Beta blockers in Congestive Cardiac Failure

Jia Cao, Ian Hamilton- Craig, Jing Sun, Laurence Howes, John Edwards, Rohan Jayasinghe



There has been no head to head comparison of the clinical outcomes between bisoprolol and carvedilol, the two beta blockers most commonly used to treat congestive heart failure in Australia. There is good evidence to support the use of either agent in the setting of CHF with significant mortality and morbidity benefits. There are some fundamental differences in the pharmacological properties, mechanisms of action and dosing regimens between the two agents. Our aim was to compare the clinical outcomes and tolerability of the two agents in the management of patients with CHF


Retrospective, matched, dual parallel group analysis at a community based multi-disciplinary heart failure program. Data extraction was done by chart review. Cohort of 132 patients with heart failure (NYHA functional classes II-III, aged 28-97 years) receiving bisoprolol (n=66) or carvedilol (n=66). The Main outcome measures included all-cause mortality, re-hospitalisation rates for cardiovascular reasons, change in heart rate, change in systolic blood pressure, change in diastolic blood pressure, change in left ventricular anatomy and function as measured by left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), and left ventricular end diastolic diameter (LVEDD) and change in New York Heart Association (NYHA) functional class over a period of 12 months since the initiation of therapy.


Heart rate, systolic diastolic blood pressure, LVEF, LVEDD and LVESD at baseline and after 12 months were comparable in both groups. Re-hospitalisation rates for cardiovascular reasons, however, were significantly lower in patients receiving carvedilol (1.6±0.7) vs. (2.2±1.1) (p

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