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Comparing carvedilol and metoprolol: results of the COMET trial. The Carvedilol or Metoprolol European Trial (COMET) compared overall mortality in patients with heart failure, randomised to receive either carvedilol or metoprolol tartrate.t is important to note that in the COMET trial, carvedilol was compared with metoprolol tartrate. The MERIT-HF trial compared metoprolol succinate to placebo and it was found that metoprolol succinate reduced the mortality rate by 34% in patients with heart failure.
Drugs like metoprolol, carvedilol and bisoprolol are now also part of the drug regimen used to treat patients with chronic heart failure due to dilated cardiomyopathy (systolic dysfunction). Several trials have documented a survival benefit for patients on long-term beta-blockers.An increase in ejection fraction between 2 and 4 months after initiation of therapy is seen consistently with beta blockers used in patients with systolic heart failure (Figure 8).Carvedilol therapy (Figure 9) in the US Carvedilol Trial was associated with a 65% reduction in mortality.HENTOLAMINE. A reversible nonselective alpha blocker that has a predominant effect on the arteriolar vascular bed. In the presence of heart failure, the main effect is reduction of afterload and increased cardiac output. Reflex tachycardia is a predominant side effect with this drug.