Comparison of The Use of Carvedilol Versus Nebivolol in The Treatment of Acute Decompensation in The Patient With Chronic Heart Failure: Evaluation of Clinical Variables

Abstract

Previous trials demonstrated the safety of using beta-blockers in the acute decompensation of heart
failure; it is unknown whether the use of nebivolol translates into an improvement in clinical parameters
at 96 hours, compared to the use of carvedilol in a similar study group. Objectives: To compare the
effect of 2 treatment strategies, where the difference is made by the type of beta-blocker, in patients
with acutely decompensated chronic heart failure. Methods: A single-center, prospective, experimental,
randomized, double-blind clinical trial was carried out, 22 patients with LVEF ≤ 40% were randomly
assigned to receive carvedilol or nebivolol with daily dose increase, clinical variables were measured for
96 hours. Results: The carvedilol group reached a maximum dose of 33.3 ± 10 mg and nebivolol 9.37 ±
1.25 mg, with both treatment strategies compensation was achieved in more than 50% of the patients in
both groups, without statistically significant differences for the majority of patients. clinical variables,
except for greater weight loss in the carvedilol group, reaching an absolute reduction of 5.62 kg (95% CI
3.22-8.02 kg) versus nebivolol with 2.54 kg (95% CI 0. 14-4.94 kg) at 96 hours of follow-up (p 0.001).
Conclusions: In patients with acutely decompensated chronic heart failure and reduced LVEF, the use
of beta-blockers is safe and well tolerated, guarantees clinical improvement and rapid compensation,
with doses diuretic drops. The group with carvedilol showed greater weight reduction, compared to the
nebivolol group in the study population.