[Clinical study of the month. The MERIT-HF study].
MERIT-HF study was a multicenter, double-blind randomized placebo-controlled study which enrolled 3.991 class II-IV heart failure patients with a left ventricular ejection fraction < or = 40% who were already treated by optimal standard therapy (diuretic + ACE inhibitor or equivalent). Three thousand nine hundred ninety one patients were enrolled in the study: 2.001 received a placebo; 1.990 were assigned to metoprolol administration at the initial dose of 25 mg/day (12.5 mg for class III-IV patients) and progressively increased to a maximum daily dose of 200 mg. The study was prematurely stopped because, after an observation period of 3.980 patients x years, it demonstrated a significant mortality reduction in the treated group. All cause mortality was reduced by 34% (7.2% per patient x year vs 11%). Sudden death mortality and mortality due to progression of heart failure were reduced by 41% and 49%, respectively.
Kulbertus
H
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Service de Cardiologie, CHU, Université de Liège.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D016757:Death, Sudden, Cardiac; D004232:Diuretics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use; D008875:Middle Aged; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D008790:Metoprolol