Efecto de Carvedilol sobre Mortalidad en Diabeticos vs No Diabeticosen Insuficiencia Cardiaca moderada

Linear trend P=0.001

Dose response of carvedilol on all-cause mortality, in moderate heart failure patients.

Bristow MR et al. Circulation. 1996;94:2807-2816.

No diabetes

Diabetes

Placebo

6.25 mg

12.5 mg

25 mg

0

Riesgo de Mortalidad (%)

30

0

1.7

3.3

10.7

5

8.7

8.8

Carvedilol Dosis

30

25

20

15

10

5

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There is an increasing incidence in patients presenting with both diabetes and heart failure. Concern about glycemic control and blocking the warning signs of hypoglycemia have limited the use of beta blockers in patients with diabetes, despite overwhelming clinical trial evidence of benefit.

In the MOCHA trial, diabetic heart failure patients has a striking reduction in mortality with the beta blocker carvedilol, that was dose dependent. Carvedilol due to is nonselective beta blocking in alpha blocking does not adversely impact glycemic control and insulin sensitivity to the same degree as beta-1 selective beta blockers.