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MERIT-HF mortality and morbidity data.

A Hjalmarson1, B Fagerberg

  • 1Institute of Heart and Lung Diseases, Sahlgrenska University Hospital, Göteborg, Sweden. ake.hjalmarson@hjl.gu.se

Basic Research in Cardiology
|February 24, 2001
PubMed
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Metoprolol controlled release/extended release (CR/XL) significantly reduced mortality and hospitalizations in patients with heart failure. This beta-blocker improved survival and quality of life, demonstrating its efficacy in managing chronic heart failure symptoms.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Heart failure with reduced ejection fraction (HFrEF) is a significant cause of morbidity and mortality.
  • Standard therapy for HFrEF may not fully address all aspects of the disease, necessitating further treatment options.

Purpose of the Study:

  • To evaluate the efficacy of metoprolol controlled release/extended release (CR/XL) added to standard therapy in reducing mortality and morbidity in patients with symptomatic HFrEF.
  • To assess the impact of metoprolol CR/XL on all-cause mortality, heart failure hospitalizations, functional class, and quality of life.

Main Methods:

  • A double-blind, randomized, placebo-controlled study involving 3991 patients with chronic heart failure (NYHA class II-IV, ejection fraction ≤0.40).
  • Patients received optimal standard therapy plus either metoprolol CR/XL or placebo, with metoprolol CR/XL uptitrated to a target dose of 200 mg once daily.

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  • Primary endpoints included all-cause mortality and the composite of all-cause mortality and hospitalization; secondary endpoints included cause-specific hospitalizations and functional status.

    • Main Results:

    • Metoprolol CR/XL significantly reduced all-cause mortality by 34% (RR 0.66, p=0.0062) and sudden cardiac death by 41%.
    • Deaths from worsening heart failure were reduced by 49% (RR 0.51, p=0.0023).
    • The composite endpoint of total mortality or hospitalizations was reduced by metoprolol (RR 0.81, p=0.00012), as were hospitalizations for worsening heart failure (RR 0.69, p<0.00001).
    • Improvements were observed in NYHA functional class and patient-assessed quality of life.

    Conclusions:

    • Once-daily metoprolol CR/XL is an effective addition to standard therapy for patients with symptomatic chronic heart failure and reduced ejection fraction.
    • Metoprolol CR/XL improves survival, reduces hospitalizations for heart failure exacerbations, and enhances functional capacity and quality of life.
    • The medication was well-tolerated, with no significant difference in early discontinuation rates compared to placebo.