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Efficacy, safety an...
Efficacy, safety and tolerability of metoprolol CR/XL in patients with diabetes and chronic heart failure: experiences from MERIT-HF
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Deedwania, P. C. (author)
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Giles, T. D. (author)
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Klibaner, M. (author)
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Ghali, J. K. (author)
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- Herlitz, Johan, 1949 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute,[external]
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Hildebrandt, P. (author)
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Kjekshus, J. (author)
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Spinar, J. (author)
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Vitovec, J. (author)
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Stanbrook, H. (author)
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- Wikstrand, John, 1938 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Wallenberglaboratoriet,Cardiovascular Institute,Wallenberg Laboratory
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(creator_code:org_t)
- Mosby, Inc. 2005
- 2005
- English.
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In: Am Heart J. - : Mosby, Inc.. - 1097-6744 .- 0002-8703. ; 149:1, s. 159-67
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https://gup.ub.gu.se...
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Abstract
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- BACKGROUND: The objective of the current study was to examine the efficacy and tolerability of the beta-blocker metoprolol succinate controlled release/extended release (CR/XL) in patients with diabetes in the Metoprolol CR/XL Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF). METHODS: The Cox proportional hazards model was used to calculate hazard ratios (HR) for convenience expressed as relative risks (risk reduction = 1-HR), and 95% confidence intervals (CI). RESULTS: The risk of hospitalization for heart failure was 76% higher in diabetics compared to non-diabetics (95% CI 38% to 123%). Metoprolol CR/XL was well tolerated and reduced the risk of hospitalization for heart failure by 37% in the diabetic group (95% CI 53% to 15%), and by 35% in the non-diabetic group (95% CI 48% to 19%). Pooling of mortality data from the Cardiac Insufficiency Bisoprolol Study II (CIBIS II), MERIT-HF, and the Carvedilol Prospective Randomized Cumulative Survival Study (COPERNICUS) showed similar survival benefits in patients with diabetes (25%; 95% CI 40% to 4%) and without diabetes (36%; 95% CI 44% to 27%); test of diabetes by treatment interaction was non-significant. Adverse events were reported more often on placebo than on metoprolol CR/XL. CONCLUSIONS: Patients with heart failure and diabetes have a much higher risk of hospitalization than patients without diabetes. Regardless of diabetic status, a highly significant reduction in hospitalizations for heart failure was observed with metoprolol CR/XL therapy, which was very well tolerated also by patients with diabetes. Furthermore, the pooled data showed a statistically significant survival benefit in patients with diabetes.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Adrenergic beta-Antagonists/adverse effects/*therapeutic use
- Adult
- Aged
- Delayed-Action Preparations
- Diabetes Complications/*drug therapy/mortality
- Diabetes Mellitus/mortality
- Double-Blind Method
- Female
- Heart Failure
- Congestive/complications/*drug therapy
- Hospitalization
- Humans
- Male
- Metoprolol/adverse effects/*analogs & derivatives/*therapeutic use
- Middle Aged
- Proportional Hazards Models
- Risk
- Survival Analysis
Publication and Content Type
- ref (subject category)
- art (subject category)
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Am Heart J
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- By the author/editor
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Deedwania, P. C.
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Giles, T. D.
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Klibaner, M.
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Ghali, J. K.
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Herlitz, Johan, ...
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Hildebrandt, P.
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show more...
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Kjekshus, J.
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Spinar, J.
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Vitovec, J.
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Stanbrook, H.
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Wikstrand, John, ...
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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 Endocrinology an ...
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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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Am Heart J
- By the university
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University of Gothenburg
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University of Borås