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Carvedilol Or Metoprolol European Trial

COMET Trial. Carvedilol Or Metoprolol European Trial . Presented at European Heart Failure Meeting 2003. COMET Trial. 3,029 patients with Class III-IV heart failure Enrolled at 317 centers in 15 European countries. Metoprolol tartrate (target dose 50 mg twice daily)

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Carvedilol Or Metoprolol European Trial

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  1. COMET Trial Carvedilol Or Metoprolol European Trial Presented at European Heart Failure Meeting 2003

  2. COMET Trial 3,029 patients with Class III-IV heart failure Enrolled at 317 centers in 15 European countries • Metoprolol tartrate • (target dose 50 mg twice daily) • A beta-1 blockade agent • (n = 1,518) • Carvedilol • (target dose 25 mg twice daily) • A multiple adrenergic inhibitor • (n = 1,511) • Endpoints (mean follow-up 58 months): • Primary – 1) All-cause mortality and 2) All-cause mortality or all-cause hospitalization • Secondary – Composite of all cause mortality or cardiovascular hospitalization; Composite of cardiovascular death, non-fatal acute MI, or heart transplantation; Worsening of heart failure; Cardiovascular death; NYHA class European Heart Failure Meeting 2003

  3. COMET Trial: Primary Endpoint Analysis All-cause mortality HR 0.83 95% CI 0.74-0.93 p=0.0017 European Heart Failure Meeting 2003

  4. COMET Trial: Primary Endpoint Analysis All-cause mortality or all-cause hospitalization HR 0.93 95% CI 0.86-1.10 p=0.1222 European Heart Failure Meeting 2003

  5. COMET: Dosing Issues Metoprolol-Tartrate (immediate release) Target dose: 2 x 50 mg tartrate ~78 mg Metoprolol Metoprolol Succinate Metoprolol Tartrate COMET Metoprolol-Succinate (CR/XR) Target dose: 1 x 190 mg succinate ~155 mg Metoprolol (achieved mean dose in MERIT-HF ~130 mg) MERIT-HF Slide Provided by: Dr. med. M. Elsner, Medizinische Klinik I, St. Josefs Hospital, Solmsstr. 15, 65189, Wiesbaden, Germany, Tel./Fax: +49-611-177-1205. Dr. Elsner has no conflict of interest to declare.

  6. COMET Trial: Summary • First randomized morality trial to compare 2 beta-blockers in patients with CHF • Treatment with carvedilol was associated with  rate of all-cause mortality (primary endpoint) but was not associated with difference in co-primary endpoint of all-cause mortality or all-cause hospitalization in patients with CHF • Trial used immediate-release formulation of metoprolol tartrate not controlled-release formulation of metoprolol succinate used in MERIT HF trial, the main trial showing a benefit of metoprolol compared with placebo in heart failure patients

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