USCTPCOPERNICUSCAPRICORNCARMENaCOMETbMOCHAPRECISECOLUCCI et al.

Patients (n)

1094

2289

1959

479

3029

278

366

NYHA class

II–IV

NA

NA

I–III

II–IV

II–III

II–III

II

LVEF

≤35%

〈25%

Post-MI ≤40%

≤39%

26%

23%

22%

23%

Mean follow-up (months)

6.5

10.4

15

18

58

6

6

12

Mean dose achieved (mg/day)

45

37

20

CAR: 47.9c CAR: 48.7d

CAR: 41.8 MET: 85.0

6.25 12.5 bd 25.0

6.25 bd upwards

6.25 bd

Primary endpoint

Safety

All-cause mortality

All-cause mortality or all-cause mortality or CV hospitalization combined

LV remodelling

All-cause mortality

Exercise tolerance Quality of life

Improved EF

CHF progression^

Results

All-cause mortality reduced 65%e

All-cause mortality reduced 35%

All-cause mortality reduced 23%

LVESVI reduced in combination with enalapril

17% relative risk reduction in favour of carvedilol

All-cause mortality reduced 73%

Morbidity and mortality reduced

Mortality Hospitalization EF^^ all reduced

p value

0.0001

0.00013

0.031

〈0.002

0.0017

0.001 Hospitalization rate 0.01

0.001/0.029

^0.008 ^^0.03

USCTPCOPERNICUSCAPRICORNCARMENaCOMETbMOCHAPRECISECOLUCCI et al.

Patients (n)

1094

2289

1959

479

3029

278

366

NYHA class

II–IV

NA

NA

I–III

II–IV

II–III

II–III

II

LVEF

≤35%

〈25%

Post-MI ≤40%

≤39%

26%

23%

22%

23%

Mean follow-up (months)

6.5

10.4

15

18

58

6

6

12

Mean dose achieved (mg/day)

45

37

20

CAR: 47.9c CAR: 48.7d

CAR: 41.8 MET: 85.0

6.25 12.5 bd 25.0

6.25 bd upwards

6.25 bd

Primary endpoint

Safety

All-cause mortality

All-cause mortality or all-cause mortality or CV hospitalization combined

LV remodelling

All-cause mortality

Exercise tolerance Quality of life

Improved EF

CHF progression^

Results

All-cause mortality reduced 65%e

All-cause mortality reduced 35%

All-cause mortality reduced 23%

LVESVI reduced in combination with enalapril

17% relative risk reduction in favour of carvedilol

All-cause mortality reduced 73%

Morbidity and mortality reduced

Mortality Hospitalization EF^^ all reduced

p value

0.0001

0.00013

0.031

〈0.002

0.0017

0.001 Hospitalization rate 0.01

0.001/0.029

^0.008 ^^0.03

a

Compared with enalapril alone or in combination with enalapril.

b

Carvedilol vs metoprolol.

c

Dose of carvedilol achieved as monotherapy.

d

Dose of carvedilol achieved as part of combination therapy with enalapril.

e

Endpoint.

CAPRICORN, Carvedilol Postinfarct Survival Controlled Evaluation; CAR, carvedilol; CARMEN, Carvedilol Ace Inhibitor Remodelling Mild Heart Failure Evaluation; COMET, Carvedilol or Metoprolol European Trial; COPERNICUS, Carvedilol Prospective Randomized Cumulative Survival; LVEF, left ventricular ejection fraction; LVESVI, left ventricular end-systolic volume index; MET, metoprolol; MI, myocardial infarction; NYHA, New York Heart Association class; RRR, relative risk reduction; USCTP, US Carvedilol Heart Failure Study Programme.

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