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Carvedilol Not Linked to Better Heart Outcomes in Youths

Study design, differences between causes in adult and youth heart failure could explain results

TUESDAY, Sept. 11 (HealthDay News) -- In what one editorialist called a disappointing finding, carvedilol does not offer significant improvement in clinical heart failure outcomes for children and adolescents with systolic heart failure, according to study findings published in the Sept. 12 issue of the Journal of the American Medical Association.

Robert E. Shaddy, M.D., of the University of Utah School of Medicine in Salt Lake City, and colleagues enrolled 161 subjects younger than 18 who had chronic heart failure due to systemic ventricular systolic dysfunction. For eight months, participants received conventional medications for heart failure, then low-dose or high-dose carvedilol, or a placebo.

When it came to how many patients worsened, improved or remained unchanged during the study, there was no difference between treatment groups. However, results suggested the drug's usefulness may vary depending on the patient's ventricular morphology; it showed benefit in patients with a systemic left ventricle, but not in those whose systemic ventricle wasn't a left ventricle.

"It is unclear why carvedilol would be beneficial in adults with heart failure but not in children and adolescents," write the authors, who point out that the results might have been influenced by several study parameters. "It is possible that the differences in the etiologies of heart failure in children and adolescents (dilated cardiomyopathy and congenital heart disease) compared with adults (primarily ischemic heart disease) could influence its efficacy."

Several of the study authors have financial ties to GlaxoSmithKline.

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