Evidence map›Paper›PMID 30592068›Full record

ArticleClinical cardiology2019

A comparison of anti-arrhythmic efficacy of carvedilol vs metoprolol succinate in patients with implantable cardioverter-defibrillators.

Mohamed Ayan, Fuad Habash, Bilal Alqam, Zaid Gheith, Michael Cross, Srikanth Vallurupalli, Hakan Paydak

Open access · hybridAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Carvedilol versus Metoprolol in Patients with Ventricular Tachyarrhythmias.Journal of cardiovascular development and disease · 2022
    Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Mohamed AyanDivision of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.ORCID https://orcid.org/0000-0003-3672-1881
Fuad HabashDivision of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Bilal AlqamDivision of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Zaid GheithDivision of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Michael CrossDivision of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Srikanth VallurupalliDivision of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.ORCID https://orcid.org/0000-0002-2404-1152
Hakan PaydakDivision of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
University of Arkansas Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effects of carvedilol and metoprolol succinate on appropriate and inappropriate implantable cardioverter defibrillator (ICD) therapy in patients with heart failure with reduced ejection fraction (HFrEF) are not fully understood. HYPOTHESIS: The hypothesis of our study is possible carvedilol superiority over metoprolol in patients with ICD.

methodsAll patients with ICD registered to a single device clinic between 1/2012 and 6/2017 (n = 569) were identified. Patients with systolic heart failure (left ventricular ejection fraction ≤40%) treated with carvedilol vs metoprolol succinate were compared. Primary endpoint was difference in survival free of appropriate device therapy (shock or anti-tachycardia pacing, ATP). Secondary endpoints were freedom from inappropriate therapy (shock or ATP) and all cause death.

resultsA total of 225 patients were included in the analysis with median follow up of 57 months (IQR 33.7-90). The 2 groups were comparable in the baseline characteristics. Carvedilol was superior to metoprolol succinate in improving survival free of appropriate ICD therapy (HR 0.42; 95% CI 0.24-0.72, P = 0.01). This difference was driven by reduction in survival free of appropriate shocks (HR 0.30; 95% CI 0.15-0.63, P = -0.01) while there was no significant difference in appropriate ATP (HR 0.55; 95% CI 0.28-1.1, P = 0.12). There was no significant difference in time to inappropriate shocks (HR 1.02; 95% CI 0.19-5.6, P = 0.97), inappropriate ATP (HR 0.93, OR 0.24-3.5, p value 0.9) or all cause death (HR 0.8; 95% CI 0.42-1.5, P = 0.52).

conclusionsThis study suggests that carvedilol use was associated with improved survival free of appropriate ICD therapy compared to metoprolol succinate in patients with HFrEF.

Indexed as

Defibrillators, ImplantableAdrenergic beta-AntagonistsAnti-Arrhythmia AgentsArkansasCarvedilolCause of DeathDeath, Sudden, CardiacFemaleFollow-Up StudiesHeart FailureHumansIncidenceMaleMetoprololMiddle AgedRetrospective StudiesAdrenergic beta-AntagonistsAnti-Arrhythmia AgentsCarvedilolMetoprololappropriate therapycardiomyopathycarvedilolimplantable cardioverter-defibrillatorinappropriate therapymetoprolol succinate

Identifiers

PMID30592068
PMCPMC6712318
OpenAlexW2906986615

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.