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Efficacy, Safety and Tolerability of Metoprolol CR/XL in Patients With Diabetes and Chronic Heart Failure: Experiences From MERIT-HF
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2005 (English)In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 149, no 1, 159-167 p.Article in journal (Refereed) Published
Abstract [en]

Background: The objective of the current study was to examine the efficacy and tolerability of the β-blocker metoprolol succinate controlled release/extended release (CR/XL) in patients with diabetes in the Metoprolol CR/XL Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF). Methods: The Cox proportional hazards model was used to calculate hazard ratios (HR) for convenience expressed as relative risks (risk reduction = 1-HR), and 95% confidence intervals (CI). Results: The risk of hospitalization for heart failure was 76% higher in diabetics compared to non-diabetics (95% CI 38% to 123%). Metoprolol CR/XL was well tolerated and reduced the risk of hospitalization for heart failure by 37% in the diabetic group (95% CI 53% to 15%), and by 35% in the non-diabetic group (95% CI 48% to 19%). Pooling of mortality data from the Cardiac Insufficiency Bisoprolol Study II (CIBIS II), MERIT-HF, and the Carvedilol Prospective Randomized Cumulative Survival Study (COPERNICUS) showed similar survival benefits in patients with diabetes (25%; 95% CI 40% to 4%) and without diabetes (36%; 95% CI 44% to 27%); test of diabetes by treatment interaction was non-significant. Adverse events were reported more often on placebo than on metoprolol CR/XL. Conclusions: Patients with heart failure and diabetes have a much higher risk of hospitalization than patients without diabetes. Regardless of diabetic status, a highly significant reduction in hospitalizations for heart failure was observed with metoprolol CR/XL therapy, which was very well tolerated also by patients with diabetes. Furthermore, the pooled data showed a statistically significant survival benefit in patients with diabetes.

Place, publisher, year, edition, pages
Mosby, Inc. , 2005. Vol. 149, no 1, 159-167 p.
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Endocrinology and Diabetes Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:hb:diva-8032DOI: 10.1016/j.ahj.2004.05.056Local ID: 2320/8923OAI: oai:DiVA.org:hb-8032DiVA: diva2:888915
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2017-08-23Bibliographically approved

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Herlitz, Johan
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