Photo Credit: Nuttiwut Rodbangpong
The following is a summary of “Efficacy of beta-blockers and angiotensin-converting enzyme inhibitors in non-ischemic dilated cardiomyopathy: A systematic review and meta-analysis,” published in the August 2024 issue of Cardiology by Llerena-Velastegui et al.
Non-ischemic dilated cardiomyopathy (NIDCM) is a type of heart failure with a grim outlook and uncertain best treatment options. Beta-blockers and angiotensin-converting enzyme (ACE) inhibitors are often used, but their effectiveness is unclear.
Researchers conducted a retrospective study evaluating how safe and effective beta-blockers and ACE inhibitors are in managing chronic heart failure caused by NIDCM while exploring how they might work.
They reviewed studies from 1990 to 2023 using PubMed and EMBASE, focusing on how beta-blockers and ACE inhibitors impacted left ventricular ejection fraction (LVEF) in patients with NIDCM. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
The results showed that Beta-blockers showed a significant beneficial effect on LVEF improvement in NIDCM, with an overall effect size of Cohen’s d = 1.30, (95% CI: 0.76-1.84) and high heterogeneity (Tau2= 0.90, Chi2= 162.05, df= 13, P<0.00001; I2=92%), and a significant overall effect (Z=4.72, P<0.00001). The ACE inhibitors also showed a beneficial role, but with less heterogeneity (Tau2 = 0.02, Chi2= 1.09, df =1, P=0.30, I2=8%) and a nonsignificant overall effect (Z=1.36, P=0.17), 95% CI: (-0.24 to 1.31).
Investigators concluded that carvedilol is more effective than ACE inhibitors in improving LVEF for patients with NIDCM, recommending beta-blockers as the first choice for treatment and suggesting more research to explore the role of ACE inhibitors further.
Source: cardiologyres.org/index.php/Cardiologyres/article/view/1653/1599
