Effect of metoprolol on quality of life in the Prevention of Syncope Trial.
BACKGROUND
Vasovagal syncope is common, often recurrent, and reduces quality of life. No therapies have proven useful to improve quality of life in adequately designed randomized clinical trials. Beta-blockers have mixed evidence for effectiveness in preventing syncope.


METHODS
The Prevention of Syncope Trial was a randomized, placebo-controlled, double-blind, multinational, clinical trial that tested the hypothesis that metoprolol improves quality of life in adult patients with vasovagal syncope in a 1-year observation period. Randomization was stratified in strata of patients <42 and > or =42 years old. The quality of life questionnaires Short Form-36 (SF-36) and Euroqol EQ-5D were completed at baseline and after 6 and 12 months of treatment by 204, 132, and 121 patients, respectively.


RESULTS
There were 208 patients, mean age 42 +/- 18, of whom 134 (64%) were females. All had positive tilt tests. There was no improvement in quality of life during the trial in the entire group or in either treatment arm. Patients in the metoprolol treatment arm did not have improved quality of life compared to the patients in the placebo arm using either the SF-36 or EQ5D after either 6 or 12 months. Finally, there was no improvement in quality of life associated with metoprolol use in patients either <42 or > or =42 years of age.


CONCLUSIONS
Metoprolol does not improve quality of life in patients with recurrent vasovagal syncope and a positive tilt test.
Sheldon
Robert S
RS
University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada. sheldon@ucalgary.ca
Amuah
Joseph E
JE
Connolly
Stuart J
SJ
Rose
Sarah
S
Morillo
Carlos A
CA
Talajic
Mario
M
Kus
Teresa
T
Fouad-Tarazi
Fetnat
F
Klingenheben
Thomas
T
Krahn
Andrew D
AD
Koshman
Mary-Lou
ML
Ritchie
Debbie
D
D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D038622:Internationality; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D016896:Treatment Outcome