COMPARATIVE EFFICACY OF CHRONIC HEART FAILURE TREATMENT WITH PERINDOPRIL OR CARVEDILOL IN PATIENTS WITH ALCOHOLIC OR IDIOPATHIC DILATED CARDIOMYOPATHY

Abstract

Aim. To study the clinical and hemodynamic efficacy of monotherapy with ACE inhibitor perindopril or beta-blocker carvedilol in patients with chronic heart failure (CHF) due to dilated cardiomyopathy (DCMP) of various etiology.Material and methods. Patients (n=69) with DCMP of different etiology were included into the open randomized study. Idiopathic DCMP (IDCMP) was diagnosed in 26 patients and alcoholic cardiomyopathy (ACMP) - in 43 patients. Patients of IDCMP and ACMP groups were randomized for treatment with perindopril (groups 1 and 3, respectively) or carvedilol (groups 2 and 4, respectively). Follow-up was 6 months. End-diastolic and end-systolic left ventricular volume, stroke volume index, ejection fraction (EF) and exercise capacity were determined at baseline and in 2 and 6 months of treatment. Safety of the treatments was also assessed.Results. Group 1: the average CHF class (NYHA) decreased by 20.7% (p<0.01), EF increased by 18.2% (p<0.05). Group 2: the average CHF class decreased by 29.6% (p<0.01), EF increased by 18.2% (p<0.05). Group 3: the average CHF class decreased by 14.3% (p<0.01), EF increased by 19.6% (p<0.05). Group 4: the average CHF class decreased by 41.4% (p<0.001), EF increased by 32.8% (p<0.001).Conclusion. Monotherapy with carvedilol in patients with ACMP was more effective than this with perindopril. Long-term monotherapy with perindopril or carvedilol in patients with DCMP was well tolerated and safety.

Keywords

• dilated cardiomyopathy
• chronic alcohol abuse
• chronic heart failure
• carvedilol
• perindopril
• new strategy to reduce alcohol consumption
• nalmefene