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A description of the clinical characteristics at baseline of patients recruited into the Carvedilol or Metoprolol European Trial (COMET)

Cleland, JGF; Goode, K; Erhardt, Leif RW LU ; Remme, WJ; Charlesworth, A; Poole-Wilson, PA; Di Lenarda, A; Hanrath, P; Komajda, M and Metra, M, et al. (2004) In Cardiovascular Drugs and Therapy 18(2). p.139-152
Abstract
Background & Aims: The COMET trial was a prospective, double-blind, randomised trial comparing carvedilol, a comprehensive adrenergic receptor antagonist, with metoprolol, a beta-1-selective agent in patients with heart failure and left ventricular systolic dysfunction. The trial showed a reduction in mortality with carvedilol that was consistent across subgroups. The purpose of this report is to describe in greater detail the heterogeneity of this population at baseline with particular reference to the impact of symptomatic severity, age and gender on patient characteristics. Methods: A descriptive report using data entered in the COMET study data-base. Results: The characteristics of the population studied were similar to those... (More)
Background & Aims: The COMET trial was a prospective, double-blind, randomised trial comparing carvedilol, a comprehensive adrenergic receptor antagonist, with metoprolol, a beta-1-selective agent in patients with heart failure and left ventricular systolic dysfunction. The trial showed a reduction in mortality with carvedilol that was consistent across subgroups. The purpose of this report is to describe in greater detail the heterogeneity of this population at baseline with particular reference to the impact of symptomatic severity, age and gender on patient characteristics. Methods: A descriptive report using data entered in the COMET study data-base. Results: The characteristics of the population studied were similar to those reported in previous trials of beta-blockers. Almost all patients were receiving diuretics and ACE inhibitors with few patients taking angiotensin receptor blockers. As expected, older patients had more co-morbidity. Older patients and women reported worse symptoms and poorer well-being despite similar ventricular dimensions and systolic dysfunction. NT-proBNP was higher in patients with more severe symptoms and older patients but not in women, although differences in NT-proBNP may have been confounded by differences in renal function. Conclusion: Age and gender, as well as the severity of cardiac dysfunction, appear to have an important effect on the severity of heart failure symptoms and patient 'well-being'. This could have important implications for the relationship between symptoms and prognosis and therefore the way in which patients are selected for clinical trials and the goals of treatment. This will be the subject of further analyses. (Less)
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organization
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Contribution to journal
publication status
published
subject
keywords
heart failure, metoprolol, carvedilol
in
Cardiovascular Drugs and Therapy
volume
18
issue
2
pages
139 - 152
publisher
Springer
external identifiers
  • pmid:15162076
  • wos:000221639700009
  • scopus:3342939305
ISSN
0920-3206
DOI
10.1023/B:CARD.0000029032.46744.56
language
English
LU publication?
yes
id
8444f029-5d09-4561-b1d1-20e3e2c6d0c5 (old id 898964)
date added to LUP
2008-01-10 13:41:27
date last changed
2017-01-01 07:21:27
@article{8444f029-5d09-4561-b1d1-20e3e2c6d0c5,
  abstract     = {Background & Aims: The COMET trial was a prospective, double-blind, randomised trial comparing carvedilol, a comprehensive adrenergic receptor antagonist, with metoprolol, a beta-1-selective agent in patients with heart failure and left ventricular systolic dysfunction. The trial showed a reduction in mortality with carvedilol that was consistent across subgroups. The purpose of this report is to describe in greater detail the heterogeneity of this population at baseline with particular reference to the impact of symptomatic severity, age and gender on patient characteristics. Methods: A descriptive report using data entered in the COMET study data-base. Results: The characteristics of the population studied were similar to those reported in previous trials of beta-blockers. Almost all patients were receiving diuretics and ACE inhibitors with few patients taking angiotensin receptor blockers. As expected, older patients had more co-morbidity. Older patients and women reported worse symptoms and poorer well-being despite similar ventricular dimensions and systolic dysfunction. NT-proBNP was higher in patients with more severe symptoms and older patients but not in women, although differences in NT-proBNP may have been confounded by differences in renal function. Conclusion: Age and gender, as well as the severity of cardiac dysfunction, appear to have an important effect on the severity of heart failure symptoms and patient 'well-being'. This could have important implications for the relationship between symptoms and prognosis and therefore the way in which patients are selected for clinical trials and the goals of treatment. This will be the subject of further analyses.},
  author       = {Cleland, JGF and Goode, K and Erhardt, Leif RW and Remme, WJ and Charlesworth, A and Poole-Wilson, PA and Di Lenarda, A and Hanrath, P and Komajda, M and Metra, M and Swedberg, K and Trop-Pedersen, C},
  issn         = {0920-3206},
  keyword      = {heart failure,metoprolol,carvedilol},
  language     = {eng},
  number       = {2},
  pages        = {139--152},
  publisher    = {Springer},
  series       = {Cardiovascular Drugs and Therapy},
  title        = {A description of the clinical characteristics at baseline of patients recruited into the Carvedilol or Metoprolol European Trial (COMET)},
  url          = {http://dx.doi.org/10.1023/B:CARD.0000029032.46744.56},
  volume       = {18},
  year         = {2004},
}