17042
document
A description of the clinical characteristics at baseline of patients recruited into the Carvedilol or Metoprolol European Trial ( COMET ) . BACKGROUND & AIMS The COMET trial was a prospective , double-blind , randomised trial comparing carvedilol , a comprehensive adrenergic receptor antagonist , with metoprolol , a beta-1-selective agent in patients with heart failure and left ventricular systolic dysfunction . The trial showed a reduction in mortality with carvedilol that was consistent across subgroups . The purpose of this report is to describe in greater detail the heterogeneity of this population at baseline with particular reference to the impact of symptomatic severity , age and gender on patient characteristics . METHODS A descriptive report using data entered in the COMET study data-base . RESULTS The characteristics of the population studied were similar to those reported in previous trials of beta-blockers . Almost all patients were receiving diuretics and ACE inhibitors with few patients taking angiotensin receptor blockers . As expected , older patients had more co-morbidity . Older patients and women reported worse symptoms and poorer well-being despite similar ventricular dimensions and systolic dysfunction . NT-proBNP was higher in patients with more severe symptoms and older patients but not in women , although differences in NT-proBNP may have been confounded by differences in renal function . CONCLUSION Age and gender , as well as the severity of cardiac dysfunction , appear to have an important effect on the severity of heart failure symptoms and patient 'well-being ' . This could have important implications for the relationship between symptoms and prognosis and therefore the way in which patients are selected for clinical trials and the goals of treatment . This will be the subject of further analyses .
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Intervention_Pharmacological
Carvedilol
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Intervention_Pharmacological
Metoprolol
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Intervention_Pharmacological
COMET
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Intervention_Pharmacological
carvedilol
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Intervention_Pharmacological
antagonist
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Intervention_Pharmacological
metoprolol
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Intervention_Pharmacological
beta-1-selective agent
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Intervention_Pharmacological
carvedilol
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Intervention_Pharmacological
COMET
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Intervention_Pharmacological
diuretics
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Intervention_Pharmacological
ACE inhibitors
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Intervention_Physical
angiotensin receptor blockers
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Outcome_Mortality
mortality
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Outcome_Physical
co-morbidity .
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Outcome_Physical
symptoms
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Outcome_Other
and
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Outcome_Physical
poorer well-being
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Outcome_Physical
ventricular dimensions and systolic dysfunction . NT-proBNP
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Outcome_Physical
renal function .
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Outcome_Physical
heart failure symptoms
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Outcome_Physical
patient 'well-being '
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Outcome_Other
.
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Participant_Condition
heart failure
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Participant_Condition
left ventricular systolic dysfunction