Dose of metoprolol CR/XL and clinical outcomes in patients with heart failure: analysis of the experience in metoprolol CR/XL randomized intervention trial in chronic heart failure (MERIT-HF).

摘要: Abstract Objectives We performed a post-hoc subgroup analysis in the Metoprolol CR/XL Randomized Intervention Trial Chronic Heart Failure (MERIT-HF) with aim of reporting on heart rate (HR) response during titration phase and clinical outcomes from three-month follow-up visit to end study two dosage subgroups: one that had reached more than 100 mg metoprolol once daily (high-dose group; n = 1,202; mean 192 mg) or less (low-dose 412; 76 mg). Background Clinicians have questioned whether patients need reach target beta-blocker dose receive benefit. Methods Outcome (Cox-adjusted) was compared all placebo available at (n 1,845). Results Data indicated somewhat higher risk low-dose group high-dose group. reduced similar degree groups, indicating sensitivity for beta-blockade The reduction total mortality similar: 38% (95% confidence interval [CI], 16 55) (p 0.0022) also CI, 11 57) 0.010). Conclusions Risk high- subgroups, which, least partly, may be result as judged HR response. results support idea an individualized dose-titration regimen, which is guided by patient tolerability Further research needed shed light why some respond marked relatively small beta-blocker.