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Therapeutics
Carvedilol was more effective than metoprolol tartrate for lowering mortality in chronic heart failure

https://doi.org/10.1136/ebm.9.1.14

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    Poole-Wilson PA, Swedberg K, Cleland JG, et al. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol Or Metoprolol European Trial (COMET): randomised controlled trial. Lancet 2003;362:7–13.
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 Q In patients with chronic heart failure (CHF), what is the comparative effectiveness of carvedilol and metoprolol tartrate on morbidity and mortality?

    Clinical impact ratings Internal medicine ★★★★★★☆ IM/Ambulatory ★★★★★★☆ Cardiology ★★★★★★☆

    METHODS

    Embedded ImageDesign:

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

    Embedded ImageAllocation:

    {concealed*}†.

    Embedded ImageBlinding:

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

    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, 99% white) with symptomatic CHF and left ventricular ejection fraction ⩽0.35. Patients had ⩾1 cardiovascular admission in the previous 2 years and were on stable heart failure treatment with angiotensin converting enzyme inhibitors for ⩾4 weeks and treatment …

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    Footnotes

    • ↵* See glossary.

    • ↵† Information provided by author.

    • Abstract and commentary also appear in ACP Journal Club.

    • For correspondence: Professor P A Poole-Wilson, National Heart and Lung Institute, London, UK. p.poole-wilsonimperial.ac.uk

    • Sources of funding: F Hoffman La Roche and GlaxoSmithKline.

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