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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
- Article/chapterEnglish2005
Publisher, publication year, extent ...
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2005-07-21
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Oxford University Press (OUP),2005
Numbers
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LIBRIS-ID:oai:gup.ub.gu.se/52196
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https://gup.ub.gu.se/publication/52196URI
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https://doi.org/10.1093/eurheartj/ehi386DOI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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.
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Torp-Pedersen, C.
(author)
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Swedberg, Karl,1944Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute(Swepub:gu)xsweka
(author)
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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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Göteborgs universitetHjärt-kärlinstitutionen
(creator_code:org_t)
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In:European heart journal: Oxford University Press (OUP)26:21, s. 2259-680195-668X1522-9645
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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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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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- 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 ...
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European heart j ...
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University of Gothenburg