Abstract | BACKGROUND: METHODS: In a multicentre, double-blind, and randomised parallel group trial, we assigned 1511 patients with chronic heart failure to treatment with carvedilol (target dose 25 mg twice daily) and 1518 to metoprolol ( metoprolol tartrate, target dose 50 mg twice daily). Patients were required to have chronic heart failure (NYHA II-IV), previous admission for a cardiovascular reason, an ejection fraction of less than 0.35, and to have been treated optimally with diuretics and angiotensin-converting enzyme inhibitors unless not tolerated. The primary endpoints were all-cause mortality and the composite endpoint of all-cause mortality or all-cause admission. Analysis was done by intention to treat. FINDINGS: The mean study duration was 58 months (SD 6). The mean ejection fraction was 0.26 (0.07) and the mean age 62 years (11). The all-cause mortality was 34% (512 of 1511) for carvedilol and 40% (600 of 1518) for metoprolol (hazard ratio 0.83 [95% CI 0.74-0.93], p=0.0017). The reduction of all-cause mortality was consistent across predefined subgroups. The composite endpoint of mortality or all-cause admission occurred in 1116 (74%) of 1511 on carvedilol and in 1160 (76%) of 1518 on metoprolol (0.94 [0.86-1.02], p=0.122). Incidence of side-effects and drug withdrawals did not differ by much between the two study groups. INTERPRETATION:
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Authors | Philip A Poole-Wilson, Karl Swedberg, John G F Cleland, Andrea Di Lenarda, Peter Hanrath, Michel Komajda, Jacobus Lubsen, Beatrix Lutiger, Marco Metra, Willem J Remme, Christian Torp-Pedersen, Armin Scherhag, Allan Skene, Carvedilol Or Metoprolol European Trial Investigators |
Journal | Lancet (London, England)
(Lancet)
Vol. 362
Issue 9377
Pg. 7-13
(Jul 05 2003)
ISSN: 1474-547X [Electronic] England |
PMID | 12853193
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Adrenergic beta-Antagonists
- Carbazoles
- Propanolamines
- Carvedilol
- Metoprolol
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Topics |
- Adrenergic beta-Antagonists
(adverse effects, therapeutic use)
- Carbazoles
(adverse effects, therapeutic use)
- Carvedilol
- Cause of Death
- Double-Blind Method
- Female
- Follow-Up Studies
- Heart Failure
(drug therapy, mortality, physiopathology)
- Heart Rate
- Humans
- Male
- Metoprolol
(adverse effects, therapeutic use)
- Middle Aged
- Propanolamines
(adverse effects, therapeutic use)
- Treatment Outcome
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