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Carvedilol was more effective than metoprolol for preventing cardiovascular events in heart failure

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 Q In patients with heart failure (HF), what is the relative effectiveness of carvedilol and metoprolol for preventing cardiovascular events?

Clinical impact ratings Internal medicine ★★★★★★☆ Cardiology ★★★★★★☆


Embedded ImageDesign:

randomised controlled trial (Carvedilol Or Metoprolol European Trial [COMET]).

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded {patients, healthcare providers, data collectors, outcome assessors, data analysts, and monitoring committee}*.

Embedded ImageFollow up period:

mean 58 months.

Embedded ImageSetting:

{341 centres in 15 European countries}*.

Embedded ImagePatients:

3029 patients (mean age 62 y, 80% men) with stable chronic HF, left ventricular ejection fraction ⩽35%, and ⩾1 cardiovascular hospital admission in the previous year, who were being treated with an angiotensin converting enzyme inhibitor and diuretics. Exclusion criteria included important valvular disease or ventricular …

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  • * Evid Based Med 2004;9:14.

  • See glossary.

  • For correspondence: Dr W J Remme, Sticares Cardiovascular Research Foundation, Rhoon, The Netherlands. w.j.remme{at}

  • Sources of funding: F. Hoffmann-La Roche and GlaxoSmithKline.

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