Doggrell Sheila A
Doggrell Biomedical Communications, 47 Caronia Crescent, Lynfield, Auckland, New Zealand.
Expert Opin Pharmacother. 2004 Jan;5(1):205-8. doi: 10.1517/14656566.5.1.205.
Carvedilol and metoprolol are beta(1)-adrenoceptor antagonists that decrease mortality in heart failure. It is not clear whether the ancillary properties, which carvedilol has but metoprolol does not have, contribute to the beneficial effect. The Carvedilol Or Metoprolol European Trial (COMET) compared metoprolol tartrate (mean daily dose 85 mg) and carvedilol (41.8 mg) in patients with heart failure. All-cause mortality was less in the carvedilol than the metoprolol group, indicating that at these doses, carvedilol has a mortality benefit over metoprolol. However, the beta(1)-adrenoceptor blocking activity of metoprolol tartrate (assessed by a decrease in heart rate) was slightly less than with carvedilol in COMET and less than that observed in previous mortality studies with metoprolol, suggesting that the use of metoprolol tartrate was not optimal in COMET.
卡维地洛和美托洛尔是β(1)肾上腺素能受体拮抗剂，可降低心力衰竭患者的死亡率。目前尚不清楚卡维地洛所具有而美托洛尔不具有的辅助特性是否有助于产生有益效果。卡维地洛或美托洛尔欧洲试验（COMET）比较了酒石酸美托洛尔（平均日剂量85毫克）和卡维地洛（41.8毫克）在心力衰竭患者中的应用。卡维地洛组的全因死亡率低于美托洛尔组，这表明在这些剂量下，卡维地洛比美托洛尔具有更低的死亡率。然而，在COMET试验中，酒石酸美托洛尔的β(1)肾上腺素能受体阻断活性（通过心率降低来评估）略低于卡维地洛，且低于以往美托洛尔死亡率研究中观察到的水平，这表明在COMET试验中酒石酸美托洛尔的使用并非最佳。
