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MERIT-HFMetoprolol CR/XL (Controlled Release/Extended Release) Randomized Intervention Trial in Chronic Heart Failure
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MERIT-HF Study Group, Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/ XL Randomised Intervention Trial in Congestive heart failure (MERIT-HF) Lancet 1999; 353 : 2001-7.
0001; NNT=23) 34% VS VS VS Metoprolol MERIT-HF (N=2002; 95% Cl, 24-56; P<.
4 mo Carvedilol [less than or equal to] 25% (2289) MERIT-HF (3) Class II-IV HF, EF 1 y Metoprolol [less than or equal succinate to] 40% (3991) SENIORS (6) Age >70 y and 21 mo Nebivolol hospitalization for HF or EF [less than or equal to] 35% (2128) RR; 951,6 CI; Trial Primary end point P value BESTS All-cause death 0.
It was extended-release metoprolol (containing a succinate salt) that was used in MERIT-HF, (1) so the recommendation to use metoprolol in heart failure applies only to the extended release formulation.
Packer replied that while interesting, this "has to be taken with a grain of salt" because the patient numbers in the MERIT-HF subgroup analysis were too small draw firm conclusions, a point conceded by the Swedish investigator.
TABLE Selected trials of beta-blockers for systolic dysfunction Mortality reduction 95% Study Drug N (%) CI (%) US Carvedilol (1) Carvedilol 1094 (65) 39-80 COPERNICUS (2) Carvedilol 2289 (35) 19-48 MERIT-HF (3) Metoprolol 3991 (34) 19-46 CIBIS II (4) Bisoprolol 2647 (34) 19-47 BEST (5) Bucindolol 2708 (9) -0.