MERIT-HF研究PPT课件.ppt.ppt

MERIT-HF: Metoprolol CR/XL Randomized Intervention Trial in congestive Heart Failure Purpose To determine whether metoprolol controlled/extended release (CR/XL) once daily, in addition to standard therapy, can lower mortality in patients with decreased ejection fraction and symptoms of heart failure Reference MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 1999;353:2001–7. MERIT-HF: Metoprolol CR/XL Randomized Intervention Trial in congestive Heart Failure- TRIAL DESIGN - Design Randomized, double-blind, placebo-controlled Patients 3991 patients with left ventricular ejection fraction 0.40 and NYHA class II-IV heart failure, stabilized by optimum standard therapy (any combination of diuretics + ACE inhibitor) Follow up and primary endpoint Aim 2.4 years follow up. Primary endpoint all-cause mortality Treatment Patients assigned metoprolol received 12.5 (NYHA III-IV) or 25 mg (NYHA II) once daily, increasing over 8 weeks to maximum target dose 200 mg once daily MERIT-HF: Metoprolol CR/XL Randomized Intervention Trial in congestive Heart Failure- RESULTS - Study halted at mean follow up of 1 year on recommendation of independent safety committee because predefined criteria met and exceeded: All-cause mortality significantly lower in metoprolol CR/XL group (145 vs. 217, 34% risk reduction, P=0.0062) Significantly fewer cardiovascular deaths (128 vs. 203), sudden deaths (79 vs. 132) and death from worsening heart failure (30 vs. 58) Drug well tolerated, as defined by permanent early discontinuation of treatment (13.9% of metoprolol CR/XL group versus 15.3% placebo) MERIT-HF: Metoprolol CR/XL Randomized Intervention Trial in congestive Heart Failure- RESULTS continued - MERIT-HF Study Group. Lancet 1999; 353 :2001 – 7. No patients lost to follow up MERIT-HF trial profile 3991 patients randomized 2001 pati