Clinical efficacy of carvedilol treatment for dilated cardiomyopathy: A meta-analysis of randomized controlled trials

BACKGROUND: Clinical trials examining the therapeutic benefit of carvedilol on patients with dilated cardiomyopathy have reported inconsistent results. The aim of this study was to evaluate the clinical efficacy of carvedilol on patients with dilated cardiomyopathy. METHODS: PubMed, Embase, Cochrane Library, web of science, China National Knowledge Infrastructure (CNKI), Wanfang, and Chinese Scientific and Technological Journal (VIP) databases were searched for randomized controlled trials (RCTs) before March 2018. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to evaluate the effects of carvedilol on patients with dilated cardiomyopathy. RESULTS: Twenty one studies including 1146 participants were included. There were significant improvements on heart rate (HR) (WMD = –14.18, 95% CI: –17.72 to –10.63, P < .001), LVEF (WMD = 7.28, 95% CI: 6.53–8.03, P < .001), SBP (WMD = –10.74, 95% CI: –12.78 to –8.70, P < .001), DBP (WMD = –4.61, 95% CI: –7.32 to –1.90, P = .001), LVEDD (WMD = –2.76, 95% CI: −4.89 to −0.62, P = .011), LVESD (WMD = –3.63, 95% CI: –6.55 to –0.71, P = .015), LVEDV (WMD = –9.30, 95% CI: –11.89 to –6.71, P < .001), LVESV (WMD = –12.28, 95% CI: –14.86 to –9.70, P < .001) under carvedilol treatment compared with control. CONCLUSION: This meta-analysis demonstrates that carvedilol significantly improves cardiac function on patients with dilated cardiomyopathy. Further large scale, high-quality and multicenter RCTs are still required to confirm the impacts of carvedilol on patients with dilated cardiomyopathy.