More evidence benefit carvedilol (Coreg)

[JAMESFETT]

More evidence is available about the effectiveness of carvedilol (Coreg) in dilated cardiomyopathy (DCM). You may want to share this article with your physician. [Can J Cardiol 2005 (Mar);21:344-8] It does support our premise that:
1)it is very important to downgrade pro-inflammatory cytokines in DCM/PPCM
2)the immune system plays a role in development of DCM/PPCM
3)additional benefits may come even several months after diagnosis
4)carvedilol gives benefits in addition to diuretics and ACE-inhibitors (and digoxin, although I don't advocate the use of digoxin except for limited indications.

James

[jmonte]

Dr. Fett- I read about so many of the women here on Coreg and I have DCM and was never given this. Does it have to be severe to be prescribed? Should I ask my doc about it? I was initially put on Enalapril and Toprol and taken off them 6 mos later when no improvement in EF was found. I'm at 45% approx. thanks, Julie

[JAMESFETT]

Toprol succinate (long-acting) and bisoprolol (Europe) may be as effective as carvedilol (Coreg) among the effective beta-blockers. Your EF at 45 percent is quite good, and you may be symptom-free--in which case the value of adding carvedilol at this point is not clear. If you have symptoms, such as with exercise (shortness of breath, palpitations) that is different. In that case you may want to discuss with your doctor the possibility of adding carvedilol (small dose at beginning with gradual increase). One additional benefit of these particular beta-blockers and ACE-inhibitors is that they also downgrade an overactive immune system that produces pro-inflammatory cytokines, and this may provide additional benefit in case there is still an inflammatory component of the cardiomyopathy--which often is the case even months and a few years after initial diagnosis. (An ongoing inflammatory component may be indicated by a blood high sensitivity-C-Reactive Protein in excess of 5 to 10 mg/liter.)

James

[momoftwoboys]

Very interesting information. I was on Digoxin for quite a long time and eventually saw improvement while on it. I was taken off of it almost a year ago now. I still wonder about the Toprol (XL) and Coreg. I was on the Toprol for over a year and saw no improvement and then my second opinion cardiologist switched me to Coreg and I had drastic improvement in the first six weeks on it.

[marissar]

Same here I was put on Coreg made improvement. Changed to Toporol and went down hill fast. The Toporol had decreased my lv function. Changed drs and was put back on Coreg and within 4 months went from 20ef to 65ef. OMG.