在心力衰竭中，并非所有的β受体阻滞剂都一样。

In heart failure, all beta-blockers are not necessarily equal.

作者信息

Tang W H Wilson, Militello Michael, Francis Gary S

机构信息

The George M. and Linda H. Kaufman Center for Heart Failure, Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, OH 44195, USA.

出版信息

Cleve Clin J Med. 2003 Dec;70(12):1081-7. doi: 10.3949/ccjm.70.12.1081.

DOI:10.3949/ccjm.70.12.1081

PMID:14686687

Abstract

The Carvedilol or Metoprolol European Trial (COMET; Lancet 2003; 362:7-13) found that in patients with heart failure, survival appears to be better with carvedilol than with immediate-release metoprolol tartrate. Whether the target doses used were equivalent (carvedilol 25 mg twice daily vs metoprolol tartrate 50 mg twice daily) has been debated, but the COMET trial shows that drugs in the same class do not necessarily have the same effects. Given the overwhelming evidence of the benefit of carvedilol, metoprolol succinate, and bisoprolol in patients with heart failure, we should all strive to increase the use of these drugs in appropriate doses.

摘要

卡维地洛或美托洛尔欧洲试验（COMET；《柳叶刀》2003年；362卷：7 - 13页）发现，在心力衰竭患者中，使用卡维地洛的生存率似乎优于使用速释酒石酸美托洛尔。所使用的目标剂量是否等效（卡维地洛每日两次，每次25毫克，对比酒石酸美托洛尔每日两次，每次50毫克）一直存在争议，但COMET试验表明，同一类药物不一定具有相同的效果。鉴于有压倒性证据表明卡维地洛、琥珀酸美托洛尔和比索洛尔对心力衰竭患者有益，我们都应努力增加这些药物在适当剂量下的使用。