A comparison of the effects of carvedilol and metoprolol on well-being, morbidity, and mortality (the "patient journey") in patients with heart failure: a report from the Carvedilol Or Metoprolol European Trial (COMET)

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Fältnamn	Indikatorer	Metadata
000		04847naa a2200685 4500
001		oai:gup.ub.gu.se/50152
003		SwePub
008		240528s2006 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:lup.lub.lu.se:9030a1ca-917d-4fc1-90aa-9dd8ba750dbb
024	7	a https://gup.ub.gu.se/publication/501522 URI
024	7	a https://lup.lub.lu.se/record/6933482 URI
024	7	a https://doi.org/10.1016/j.jacc.2005.11.0692 DOI
040		a (SwePub)gud (SwePub)lu
041		a eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Cleland, J. G.4 aut
245	1 0	a A comparison of the effects of carvedilol and metoprolol on well-being, morbidity, and mortality (the "patient journey") in patients with heart failure: a report from the Carvedilol Or Metoprolol European Trial (COMET)
264	1	b Elsevier BV,c 2006
520		a OBJECTIVES: This study was designed to investigate the loss of well-being, in terms of life-years, overall and in patients randomized to metoprolol versus carvedilol in the Carvedilol Or Metoprolol European Trial (COMET). BACKGROUND: The ultimate objectives of treating patients with heart failure are to relieve suffering and prolong life. Although the effect of treatment on mortality is usually described in trials, the effects on patient well-being throughout the trials' courses are rarely reported. METHODS: A total of 3,029 patients randomized in the COMET study were included in the analysis. "Patient journey" was calculated by adjusting days alive and out of hospital over four years using a five-point score completed by the patient every four months, adjusted according to the need for intensification of diuretic therapy. Scores ranged from 0% (dead or hospitalized) to 100% (feeling very well). RESULTS: Over 48 months, 17% of all days were lost through death, 1% through hospitalization, 23% through impaired well-being, and 2% through the need for intensified therapy. Compared with metoprolol, carvedilol was associated with fewer days lost to death, with no increase in days lost due to impaired well-being or days in hospital. The "patient journey" score improved from a mean of 54.8% (SD 26.0) to 57.4% (SD 26.3%) (p < 0.0068). CONCLUSIONS: Despite treatment with beta-blockers, heart failure remains associated with a marked reduction in well-being and survival. Loss of quality-adjusted life-years through death and poor well-being seemed of similar magnitude over four years, and both were much larger than the loss that could be attributed to hospitalization.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653		a Adrenergic beta-Antagonists/*therapeutic use
653		a Aged
653		a Carbazoles/*therapeutic use
653		a Cardiac Output
653		a Low/drug therapy/mortality/physiopathology/therapy
653		a Chronic Disease
653		a Diuretics/administration & dosage/therapeutic use
653		a Dose-Response Relationship
653		a Drug
653		a Double-Blind Method
653		a Female
653		a Hospitalization
653		a Humans
653		a Male
653		a Metoprolol/*therapeutic use
653		a Middle Aged
653		a Propanolamines/*therapeutic use
653		a *Quality of Life
653		a Severity of Illness Index
653		a Treatment Outcome
700	1	a Charlesworth, A.4 aut
700	1	a Lubsen, J.4 aut
700	1	a Swedberg, Karl,d 1944u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine4 aut0 (Swepub:gu)xsweka
700	1	a Remme, W. J.4 aut
700	1	a Erhardt, Leif RWu Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups4 aut0 (Swepub:lu)medf-ler
700	1	a Di Lenarda, A.4 aut
700	1	a Komajda, M.4 aut
700	1	a Metra, M.4 aut
700	1	a Torp-Pedersen, C.4 aut
700	1	a Poole-Wilson, P. A.4 aut
710	2	a Göteborgs universitetb Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin4 org
773	0	t Journal of the American College of Cardiologyd : Elsevier BVg 47:8, s. 1603-11q 47:8<1603-11x 1558-3597x 0735-1097
856	4	u http://dx.doi.org/10.1016/j.jacc.2005.11.069y FULLTEXT
856	4	u https://doi.org/10.1016/j.jacc.2005.11.069
856	4 8	u https://gup.ub.gu.se/publication/50152
856	4 8	u https://lup.lub.lu.se/record/693348
856	4 8	u https://doi.org/10.1016/j.jacc.2005.11.069

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Av författaren/redakt...: Cleland, J. G.; Charlesworth, A.; Lubsen, J.; Swedberg, Karl, ...; Remme, W. J.; Erhardt, Leif RW; visa fler...; Di Lenarda, A.; Komajda, M.; Metra, M.; Torp-Pedersen, C ...; Poole-Wilson, P. ...; visa färre...

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