Sackner-Bernstein Jonathan D
Heart Failure and Cardiomyopathy Center, Division of Cardiology, North Shore University Hospital, Manhasset, New York, USA.
Rev Cardiovasc Med. 2003;4 Suppl 3:S25-9.
The CAPRICORN (Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction) trial established that the beta-blocker carvedilol reduces the risk of death in patients with left ventricular dysfunction post myocardial infarction, whether or not the infarct is complicated by clinical heart failure. Thus, the utility of the beta-blocker carvedilol is confirmed in the modern era as an adjunct to revascularization, angiotensin-converting enzyme inhibitors, aspirin, and statins. In addition, the results prompt us to review the prior studies of beta-blockers postinfarction. Critical review of CAPRICORN and earlier beta-blocker studies suggests that specific beta-blockers should be matched to specific clinical scenarios. The COMET (Carvedilol or Metoprolol European Trial) study reinforces this view by establishing that beta-blockers are not simply interchangeable agents.
卡普里角（卡维地洛治疗心肌梗死后左心室功能不全的生存控制）试验证实，β受体阻滞剂卡维地洛可降低心肌梗死后左心室功能不全患者的死亡风险，无论梗死是否合并临床心力衰竭。因此，在现代，β受体阻滞剂卡维地洛作为血管重建、血管紧张素转换酶抑制剂、阿司匹林和他汀类药物的辅助药物的效用得到了证实。此外，这些结果促使我们回顾既往关于心肌梗死后β受体阻滞剂的研究。对卡普里角试验和早期β受体阻滞剂研究的批判性回顾表明，特定的β受体阻滞剂应与特定的临床情况相匹配。卡维地洛或美托洛尔欧洲试验（COMET）研究通过证实β受体阻滞剂并非简单的可互换药物，强化了这一观点。
