Update of REACH-1 and MERIT-HF clinical trials in heart failure. Cardio.net Editorial Team.
BACKGROUND
This article reviews the design and results of REACH-1 (Research on Endothelin Antagonism in Chronic Heart Failure) and MERIT (Metoprolol controlled and Extended release, Randomised Intervention Trial in congestive Heart Failure), two recently reported clinical trials that investigated, respectively, the role of a non-selective endothelin antagonist (bosentan) and of a beta-selective blocker for the treatment of heart failure.


RESULTS
The REACH-1 trial demonstrated that initiation of bosentan therapy is associated with an increased risk of worsening heart failure. However, long-term therapy with bosentan may have improved symptoms and favourably altered the progression of heart failure. The MERIT-HF clinical trial indicated that beta-blockade using metoprolol confers a significant beneficial effect on total mortality in patients with stable chronic heart failure.
Cardio.net Editorial Office, Macclesfield, Cheshire UK.
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D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000077300:Bosentan; D004311:Double-Blind Method; D016232:Endothelins / Q000037:antagonists & inhibitors; D005060:Europe / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D013449:Sulfonamides / Q000627:therapeutic use*; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology*
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D016232:Endothelins; D013449:Sulfonamides; D008790:Metoprolol; D000077300:Bosentan