Influence of Global Region on Outcomes in Heart Failure Beta-Blocker Trials

摘要: Objectives We sought to describe the United States and rest of world (ROW) outcomes from major β-blocker heart failure (HF) trials. Background HF trials have demonstrated differences in by geographic region. Methods Randomized, double-blind, placebo-controlled studies that evaluated β-blockers patients, had a primary endpoint mortality, enrolled U.S. patients were included. Relative risk (RR) was calculated for ROW. Meta-analysis combined mortality rates performed using Cochran-Mantel-Haenszel statistic, stratified study. Results A total 8,988 MERIT-HF (Metoprolol Controlled-Release Randomized Intervention Trial Heart Failure), COPERNICUS (Carvedilol Prospective Cumulative Survival trial), BEST (β-Blocker Evaluation Trial) combined; 4,198 (46.7%) States. In cohort, RR reduction each smaller magnitude than overall cohort no longer significant, whereas ROW subgroup, benefit β-blockade persisted. pooled analysis (n = 11,635), death reduced 23% (p Conclusions Among States, associated with lower survival benefit, response similar study population. This difference treatment may be reflection population differences, genetics, cultural or social disease management, low power statistical chance.