Drug May Prevent Death After Heart Attack

Adding a drug called a beta-blocker to conventional therapy for heart attack may provide long-term benefits for some patients, researchers report.

In a study of nearly 2,000 patients given standard therapy for a heart attack, those who were also taking the drug carvedilol were less likely to die from heart disease or other causes or to have another heart attack.

Carvedilol and other beta-blockers are prescribed to treat high blood pressure and heart failure. Beta-blockers have been shown to be particularly useful in heart failure patients with a heart condition called left-ventricular systolic dysfunction when used along with drugs called angiotensin-converting-enzyme (ACE) inhibitors. Left-ventricular systolic dysfunction reduces the heart’s pumping efficiency.

Previous research has shown that the drugs may also help heart attack patients. But these studies were conducted before the widespread use of several new treatments for heart disease, including the artery-clearing procedure balloon angioplasty, clot-busting medications and ACE inhibitors. And until now, beta-blockers had not been studied in heart attack patients with left-ventricular systolic dysfunction.

Dr. Henry J. Dargie of Western Infirmary in Glasgow, Scotland, and an international team of researchers conducted a study of carvedilol in heart attack patients with left-ventricular systolic dysfunction. All patients received standard therapy for a heart attack, usually including an ACE inhibitor. Patients were randomly selected to receive either carvedilol or a placebo, which did not contain any medication. The patients were followed for an average of more than a year.

Patients taking the beta-blocker were just as likely as placebo patients to be hospitalized for cardiovascular reasons, but the drug appeared to reduce the risk of death. Individuals taking carvedilol were 23% less likely than individuals in the placebo group to die from any cause, Dargie’s team reports in the May 5th issue of The Lancet.

These patients were also less likely to die from cardiovascular disease, including heart failure, or to have another nonfatal heart attack.

The authors point out that combining carvedilol with ACE inhibitors provides more benefits than ACE inhibitors alone.

Glaxo SmithKline and Roche Pharmaceuticals were both involved in the research.

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