Commentary on the Carvedilol or Metoprolol European Trial (COMET).
beta-Adrenergic blockade is commonly and successfully used to treat chronic heart failure. Until recently, few data were available on which to base selection of a particular beta-blocking agent. The Carvedilol or Metoprolol European Trial (COMET) provides evidence that beta-blockers are not interchangeable. The trial compared carvedilol, a nonselective beta-blocker with alpha-adrenergic blocking and numerous ancillary activities, with metoprolol tartrate. In comparison to metoprolol tartrate, significant reductions in all-cause mortality and cardiovascular mortality were observed with carvedilol. These data indicate that cardiovascular benefit may be obtained from switching patients from metoprolol tartrate to carvedilol.
Poole-Wilson
Philip A
PA
National Heart and Lung Institute and Faculty of Medicine, Imperial College London, London, United Kingdom. p.poole-wilson@imperial.ac.uk
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008790:Metoprolol / Q000627:therapeutic use*; D011412:Propanolamines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D008790:Metoprolol