A comparison of the effects of carvedilol and metoprolol on well-being, morbidity, and mortality (the "patient journey") in patients with heart failure: a report from the Carvedilol Or Metoprolol European Trial (COMET)

Journal of the American College of Cardiology
J G F ClelandCOMET Investigators

Abstract

This study was designed to investigate the loss of well-being, in terms of life-years, overall and in patients randomized to metoprolol versus carvedilol in the Carvedilol Or Metoprolol European Trial (COMET). The ultimate objectives of treating patients with heart failure are to relieve suffering and prolong life. Although the effect of treatment on mortality is usually described in trials, the effects on patient well-being throughout the trials' courses are rarely reported. A total of 3,029 patients randomized in the COMET study were included in the analysis. "Patient journey" was calculated by adjusting days alive and out of hospital over four years using a five-point score completed by the patient every four months, adjusted according to the need for intensification of diuretic therapy. Scores ranged from 0% (dead or hospitalized) to 100% (feeling very well). Over 48 months, 17% of all days were lost through death, 1% through hospitalization, 23% through impaired well-being, and 2% through the need for intensified therapy. Compared with metoprolol, carvedilol was associated with fewer days lost to death, with no increase in days lost due to impaired well-being or days in hospital. The "patient journey" score improved from a...Continue Reading

References

Aug 1, 1980·British Heart Journal·K SwedbergI Wallentin
Jan 5, 2002·The New England Journal of Medicine·J N CohnUNKNOWN Valsartan Heart Failure Trial Investigators
May 30, 2002·European Journal of Heart Failure·Philip A Poole-WilsonChristian Torp-Pedersen
Sep 27, 2002·Statistics in Medicine·Jacobus Lubsen, Bridget-Anne Kirwan
Sep 19, 2003·Lancet·Marc A PfefferUNKNOWN CHARM Investigators and Committees
Nov 12, 2003·The New England Journal of Medicine·Marc A PfefferUNKNOWN Valsartan in Acute Myocardial Infarction Trial Investigators
May 27, 2004·Cardiovascular Drugs and Therapy·John G F ClelandUNKNOWN Carvedilol or Metoprolol European Trial Investigators
Feb 11, 2005·European Journal of Heart Failure·J G F ClelandUNKNOWN CARE-HF study Steering Committee and Investigators

❮ Previous
Next ❯

Citations

Jun 11, 2008·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Hans-Dirk DüngenUNKNOWN CIBIS-ELD Investigators, Subproject Multicenter Trials in the Competence Network Heart Failure
Apr 9, 2008·Heart Failure Reviews·Clare L Murphy, John J V McMurray
Nov 19, 2009·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Stephan von HaehlingMitja Lainscak
Dec 26, 2012·Heart Failure Reviews·Vincent M van DeursenAdriaan A Voors
Dec 4, 2008·Heart Failure Reviews·J Paul RocchiccioliAnna F Dominiczak
Mar 20, 2012·Heart Failure Reviews·John G F ClelandRenjith Antony
Feb 19, 2016·Nature Reviews. Cardiology·Daniel B Mark
Jan 9, 2009·Journal of the American Academy of Nurse Practitioners·Lindsey Austin ReddersenDiane Berry
Nov 29, 2008·Journal of the American College of Cardiology·Cecilia LindeUNKNOWN REVERSE (REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction) Study Group
Apr 25, 2006·Journal of the American College of Cardiology·Lynne Warner Stevenson, Eldrin Lewis
Jan 30, 2007·The Annals of Thoracic Surgery·Marco PocarFrancesco Donatelli
Oct 24, 2008·European Journal of Heart Failure·Markku S NieminenToni Sarapohja
Jul 21, 2011·Circulation. Heart Failure·Lynne Warner Stevenson, Reena Pande
Aug 14, 2019·European Journal of Heart Failure·Tariq AhmadJoann Lindenfeld
Feb 28, 2020·The Cochrane Database of Systematic Reviews·Meaghan LunneyPietro Ravani
Aug 6, 2008·European Journal of Heart Failure·Alison P ColettaAndrew L Clark
Jun 30, 2018·Therapeutic Innovation & Regulatory Science·Mouna AkachaNorman Stockbridge
Dec 14, 2011·Expert Review of Cardiovascular Therapy·James J DiNicolantonio, Daniel G Hackam
Nov 15, 2011·Heart Failure Reviews·John G F Cleland, Stefano Ghio
Oct 29, 2020·European Journal of Heart Failure·Tarek BekfaniStefan D Anker

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.