PMID- 11583861
OWN - NLM
STAT- MEDLINE
DCOM- 20011025
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 38
IP  - 4
DP  - 2001 Oct
TI  - Metoprolol controlled release/extended release in patients with severe heart 
      failure: analysis of the experience in the MERIT-HF study.
PG  - 932-8
AB  - OBJECTIVES: This study analyzed the effect of the beta(1)-selective beta-blocker 
      metoprolol succinate controlled release/extended release (CR/XL) once daily on 
      mortality, hospitalizations and tolerability in patients with severe heart 
      failure. BACKGROUND: There continues to be resistance to the incorporation of 
      beta-blockers into clinical care, largely due to concerns about their benefit in 
      patients with more severe heart failure. METHOD: SA subgroup of patients from 
      Metoprolol CR/XL Randomized Intervention Trial in chronic Heart Failure 
      (MERIT-HF) in New York Heart Association (NYHA) functional class III/IV with left 
      ventricular ejection fraction < 0.25 were identified (n = 795). The analysis was 
      by intention-to-treat. RESULTS: The mean ejection fraction at baseline was 0.19, 
      and the yearly placebo mortality during follow-up was 19.1%. Treatment with 
      metoprolol CR/XL compared to placebo resulted in significant reductions in all 
      predefined mortality end points including: total mortality, 45 versus 72 deaths 
      (risk reduction 39%; 95% confidence interval 11% to 58%; p = 0.0086); sudden 
      death, 22 vs. 39 deaths (45% [7% to 67%]; p = 0.024); and death due to worsening 
      heart failure, 13 vs. 28 deaths (55% [13% to 77%]; p = 0.015). Metoprolol CR/XL 
      also reduced the number of hospitalizations for worsening heart failure by 45% 
      compared with placebo (p < 0.0001). The NYHA functional class improved in the 
      metoprolol CR/XL group compared with placebo (p = 0.0031). Metoprolol CR/XL was 
      well tolerated, with 31% fewer patients withdrawn from study medicine (all 
      causes) compared with placebo (p = 0.027). CONCLUSIONS: This subgroup analysis of 
      the MERIT-HF study shows that patients with severe heart failure receive a 
      similar mortality benefit and a similar reduction in hospitalizations for 
      worsening heart failure with metoprolol CR/XL treatment as those patients 
      included in the total study.
FAU - Goldstein, S
AU  - Goldstein S
AD  - Henry Ford Heart and Vascular Institute, Henry Ford Hospital, Detroit, Michigan 
      48202-2689, USA. SGOLDST1@HFHS.ORG
FAU - Fagerberg, B
AU  - Fagerberg B
FAU - Hjalmarson A
AU  - Hjalmarson A
FAU - Kjekshus, J
AU  - Kjekshus J
FAU - Waagstein, F
AU  - Waagstein F
FAU - Wedel, H
AU  - Wedel H
FAU - Wikstrand, J
AU  - Wikstrand J
CN  - MERIT-HF Study Group
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Delayed-Action Preparations)
RN  - GEB06NHM23 (Metoprolol)
SB  - IM
MH  - Adrenergic beta-Antagonists/*administration & dosage
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Delayed-Action Preparations
MH  - Female
MH  - Heart Failure/*drug therapy/mortality
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Metoprolol/*administration & dosage/analogs & derivatives
MH  - Middle Aged
MH  - Multicenter Studies as Topic
MH  - Randomized Controlled Trials as Topic
EDAT- 2001/10/05 10:00
MHDA- 2001/10/26 10:01
CRDT- 2001/10/05 10:00
PHST- 2001/10/05 10:00 [pubmed]
PHST- 2001/10/26 10:01 [medline]
PHST- 2001/10/05 10:00 [entrez]
AID - S0735109701015169 [pii]
AID - 10.1016/s0735-1097(01)01516-9 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2001 Oct;38(4):932-8. doi: 10.1016/s0735-1097(01)01516-9.