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Influence of heart ...
Influence of heart rate, blood pressure, and beta-blocker dose on outcome and the differences in outcome between carvedilol and metoprolol tartrate in patients with chronic heart failure: results from the COMET trial
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Metra, M. (author)
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Torp-Pedersen, C. (author)
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- Swedberg, Karl, 1944 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute
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Cleland, J. G. (author)
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Di Lenarda, A. (author)
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Komajda, M. (author)
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Remme, W. J. (author)
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Lutiger, B. (author)
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Scherhag, A. (author)
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Lukas, M. A. (author)
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Charlesworth, A. (author)
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Poole-Wilson, P. A. (author)
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(creator_code:org_t)
- 2005-07-21
- 2005
- English.
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In: European heart journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 26:21, s. 2259-68
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https://academic.oup...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
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- AIMS: We studied the influence of heart rate (HR), systolic blood pressure (SBP), and beta-blocker dose on outcome in the 2599 out of 3029 patients in Carvedilol Or Metoprolol European Trial (COMET) who were alive and on study drug at 4 months after randomization (time of first visit on maintenance therapy). METHODS AND RESULTS: By multivariable analysis, baseline HR, baseline SBP, and their change after 4 months were not independently related to subsequent outcome. In a multivariable analysis including clinical variables, HR above and SBP below the median value achieved at 4 months predicted subsequent increased mortality [relative risk (RR) for HR>68 b.p.m. 1.333; 95% confidence intervals (CI) 1.152-1.542; P<0.0001 and RR for SBP>120 mmHg 0.78; 95% CI 0.671-0.907; P<0.0013]. Achieving target beta-blocker dose was associated with a better outcome (RR 0.779; 95% CI 0.662-0.916; P<0.0025). The superiority of carvedilol as compared to metoprolol tartrate was maintained in a multivariable model (RR 0.767; 95% CI 0.663-0.887; P=0.0004) and there was no interaction with HR, SBP, or beta-blocker dose. CONCLUSION: Beta-blocker dose, HR, and SBP achieved during beta-blocker therapy have independent prognostic value in heart failure. None of these factors influenced the beneficial effects of carvedilol when compared with metoprolol tartrate at the pre-defined target doses used in COMET.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Adrenergic beta-Antagonists/*administration & dosage
- Blood Pressure/*physiology
- Carbazoles/*administration & dosage
- Chronic Disease
- Dose-Response Relationship
- Drug
- Double-Blind Method
- Female
- Heart Failure
- Congestive/*drug therapy/mortality/physiopathology
- Heart Rate/*physiology
- Humans
- Male
- Metoprolol/*administration & dosage
- Middle Aged
- Propanolamines/*administration & dosage
- Treatment Outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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Metra, M.
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Torp-Pedersen, C ...
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Swedberg, Karl, ...
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Cleland, J. G.
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Di Lenarda, A.
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Komajda, M.
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show more...
-
Remme, W. J.
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Lutiger, B.
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Scherhag, A.
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Lukas, M. A.
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Charlesworth, A.
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Poole-Wilson, P. ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European heart j ...
- By the university
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University of Gothenburg