Carvedilol: new preparation. Encouraging but inadequate data.

(1) Carvedilol is the first betablocker to obtain approval in France for the treatment of heart failure. (2) The improvement in haemodynamic parameters was initially documented in three methodologically sound studies involving a total of 156 patients, with follow-up limited to 16 weeks. (3) A placebo-controlled, double-blind trial involving 1,094 patients showed a beneficial impact on overall mortality of 4.6% in absolute terms after a median follow-up of 6.5 months. This benefit was not found in another trial involving 415 patients followed for 19 months on average. Results for symptom-based criteria are conflicting. (4) When treatment is introduced very gradually, adverse effects seem to be minor (malaise) and infrequent. (5) The place of carvedilol in the treatment of heart failure is not yet precisely documented.