Efficacy of Different Beta Blockers in Reducing Mortality in Heart-Failure Patients

Cureus. 2024 Nov 21;16(11):e74171. doi: 10.7759/cureus.74171. eCollection 2024 Nov.

Abstract

This study evaluated the comparative efficacy of different beta blockers bisoprolol, carvedilol, and metoprolol in reducing mortality and hospitalizations among 120 heart-failure (HF) patients. The sample had an equal gender distribution (50% male, 50% female) with a mean age of 69.28 years. Baseline characteristics, such as systolic blood pressure (mean: 134.36 mmHg) and left ventricular ejection fraction (LVEF) (mean: 40.24%), were comparable across the treatment groups. Patients were treated with either bisoprolol (30%), carvedilol (30%), or metoprolol (40%) for an average of 27.54 weeks. The study utilized Poisson and negative binomial regression models to assess hospitalization rates, and chi-square tests to compare mortality outcomes. Results revealed that mortality was 44.2% across the entire cohort, with no significant differences between the three beta-blocker groups (p = 0.301). Similarly, no significant differences were observed in hospitalizations (p = 0.276) or ICU admissions (p = 0.797). However, patients on bisoprolol and carvedilol exhibited a slight improvement in New York Heart Association (NYHA) class and LVEF, though this was not statistically significant (p = 0.145 and p = 0.477, respectively). Side effects, including bradycardia, fatigue, and hypotension, were noted in 32.5%, 21.7%, and 23.3% of patients, respectively. These findings suggest that all three beta blockers are similarly effective in reducing mortality, though bisoprolol and carvedilol may offer better control of HF symptoms.

Keywords: beta blockers; bisoprolol; carvedilol; heart failure; heart failure hospitalization; left ventricle ejection fraction; mortality.