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Controlled and extended release metoprolol reduced death, hospital admissions, and symptoms in chronic heart failure
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 QUESTION: In patients with symptomatic chronic heart failure, do controlled and extended release metoprolol succinate (a β-blocker) reduce mortality, hospital admissions, and symptoms?

Design

Randomised (allocation concealed*), blinded (outcome assessor, {patients, and clinicians}),* placebo controlled trial with a mean follow up of 1 year.

Setting

313 investigational sites in the US and 13 European countries.

Patients

3991 patients (mean age 64 y, 78% men) who had had symptomatic heart failure (New York Heart Association [NYHA] class II to IV) for ≥3 months, a decreased ejection fraction (≤ 0.40), and a resting heart rate ≥68 beats/minute and had received optimal treatment for ≥2 weeks before randomisation. Exclusion criteria included acute myocardial infarction or unstable angina pectoris ≤ 28 …

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