The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Efficacy, safety and tolerability of metoprolol CR/XL in patients with diabetes and chronic heart failure: Experiences from MERIT-HF
Abstract
Background The objective of the current study was to examine the efficacy and tolerability of the beta-blocker metoprolol succinate controlled release/extended release (CR/XL) in patients with diabetes in the Metoprolol CR/XL Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF).Methods The Cox proportional hazards model was used to calculate hazard ratios (HR) for convenience expressed as relative risks (risk reduction = 1-HR), and 95% confidence intervals (CI).Results The risk of hospitalization for heart failure was 76% higher in diabetics compared to non-diabetics (95% CI 38% to 123%). Metoprolol CR/XL was well tolerated and reduced the risk of hospitalization for heart failure by 37% in the diabetic group (95% CI 53% to 15%), and by 35% in the non-diabetic group (95% CI 48% to 19%). Pooling of mortality data from the Cardiac Insufficiency Bisoprolol Study II (CIBIS II), MERIT-HF, and the Carvedilol Prospective Randomized Cumulative Survival Study (COPERNICUS) showed similar survival benefits in patients with diabetes (25%; 95% CI 40% to 4%) and without diabetes (36%; 95% CI 44% to 27%); test of diabetes by treatment interaction was non-significant. Adverse events were reported more often on placebo than on metoprolol CR/XL.Conclusions Patients with heart failure and diabetes have a much higher risk of hospitalization than patients without diabetes. Regardless of diabetic status, a highly significant reduction in hospitalizations for heart failure was observed with metoprolol CR/XL therapy, which was very well tolerated also by patients with diabetes. Furthermore, the pooled data showed a statistically significant survival benefit in patients with diabetes.
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In the citing paper
“The coexistence of type 2 diabetes mellitus (T2DM) and heart failure (HF), either with reduced (HFrEF) or preserved ejection fraction (HFpEF), is frequent (30-40% of patients)”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [37]
In the citing paper
“The highest prevalence of T2DM was seen in trials of acute HF (around 40%).”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [37]
In the citing paper
“In clinical trials of chronic HF patients, the prevalence of T2DM was around 30%, irrespective of HF phenotype (i.e.HFrEF and HFpEF) (Table 3).31 -48”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [37]
In the citing paper
“Clinical trial results are somewhat conflicting regarding the risk of all-cause and CV mortality attributed to T2DM in HF patients, but most clinical trials reported an increased risk of death in patients with concurrent T2DM and HF (Table 5).1,31 -35,37,40,42,44,45,69,88-92”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [37]
In the citing paper
“Subgroup analyses of large HF trials show that beta-blockers reduce mortality and hospitalization and improve symptoms in moderate to severe HF, irrespectively of T2DM.37,152,153”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [37]
In the citing paper
“The MERIT-HF trial reported similar efficacy and safety of metoprolol succinate in patients with and ©2018 The Authors European Journal of Heart Failure ©2018 European Society of Cardiology without T2DM.37”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [37]
Citations
Cites
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The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus* (2002) · Diabetes Care · doi:10.2337/diacare.25.2007.s5 · Cited by 10,325
Turner, R. C., Fox, C., Matthews, McElroy, H. H., Cull, C. A., Holman, R. R., Neil, P., Hadden, D. R., Wright, D., Manley, E., et al. (1998) · The Lancet · Cited by 8,419
Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (1997) · Diabetes Care · doi:10.2337/diacare.20.7.1183 · Cited by 6,220
The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial
Lechat, P. P., Brunhuber, K., Hofmann, R., Kuhn, P., Nesser, H., Slany, J., Weihs, W., Wiedermann, C. J., Wimmer, H., van Mieghem, W., et al. (1999) · The Lancet · doi:10.1016/s0140-6736(98)11181-9 · Cited by 4,922
Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes
Gæde, P., Vedel, P., Larsen, N., Jensen, G. V. H., Parving, H.-H., & Pedersen, O. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa021778 · Cited by 4,378
Effect of carvedilol on survival in severe chronic heart failure
Packer, M., Coats, A. J. S., Fowler, M. B., Katus, H. A., Krum, H., Mohacsi, P., Rouleau, J. L., Tendera, M., Castaigne, A., Roecker, E. B., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105313442201 · Cited by 3,093
Effect of carvedilol on survival in severe chronic heart failure
Packer, M., Coats, A. J. S., & Fowler, M. B. (2001) · ACC Current Journal Review · doi:10.1016/s1062-1458(01)00477-9 · Cited by 1,651
Malmberg, K., Rydén, L., Efendic, S., Herlitz, J., Nicol, P., Waldenstrom, A., Wedel, H., & Welin, L. (1995) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(95)00126-k · Cited by 1,560
Cited by
Sorted by citations
Authors Task Force Members, Rydén, L., Grant, P. J., Anker, S. D., Berne, C., Cosentino, F., Danchin, N., Deaton, C., Escaned, J., Hammes, H., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht108 · Cited by 1,994
Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary
Rydén, L., Standl, E., Bartnik, M., den Berghe, G. V., Betteridge, J. D., de Boer, M., Cosentino, F., Jönsson, B., Laakso, M., Malmberg, K., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehl260 · Cited by 1,644
2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes.
Marx, N., Federici, M., Schütt, K., Müller-Wieland, D., Ajjan, R. A., Antunes, M. J., Christodorescu, R. M., Crawford, C., Di Angelantonio, E., Eliasson, B., et al. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad192 · Cited by 1,642
Blood Pressure Lowering in Type 2 Diabetes: A Systematic Review and Meta-analysis
Emdin, C. A., Rahimi, K., Neal, B., Callender, T., Perkovic, V., & Patel, A. (2015) · JAMA · doi:10.1001/jama.2014.18574 · Cited by 854
Seferović, P. M., Petrie, M. C., Filippatos, G. S., Anker, S. D., Rosano, G., Bauersachs, J., Paulus, W. J., Komajda, M., Cosentino, F., de Boer, R. A., et al. (2018) · European Journal of Heart Failure · doi:10.1002/ejhf.1170 · Cited by 708
Metadata
- Authors
- Deedwania, P. C., Giles, T. D., Klibaner, M., Ghali, J. K., Herlitz, J., Hildebrandt, P., Kjekshus, J., Spinar, J., Vitovec, J., Stanbrook, H., & Wikstrand, J.
- Affiliations
- Veterans Health Administration (US)
- Louisiana State University (US)
- AstraZeneca (United States) (US)
- Sahlgrenska University Hospital (SE)
- Oslo University Hospital (NO)
- Corresponding author
- Deedwania, Prakash C.
- Venue
- American Heart Journal
- Publisher
- Elsevier BV
- Published
- 2005-01
- Volume
- 149
- Issue
- 1
- Pages
- 159-167
- ISSN
- 0002-8703 (ISSN-L)
- OpenAlex
- W1980524591
- Cited by
- 143
- References
- 21
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 7 · 2020: 8 · 2019: 10 · 2018: 6 · 2017: 7 · 2016: 10 · 2015: 7 · 2014: 11 · 2013: 2 · 2012: 2
- FWCI
- 9.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Borås Academic Digital Archive (University of Borås) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- metoprolol succinate, beta-blockers, chronic heart failure, diabetes mellitus, heart failure hospitalization, survival benefit, drug tolerability, adverse events, Copernicus
- MeSH terms
- Adrenergic beta-Antagonists, Adult, Aged, Delayed-Action Preparations, Diabetes Mellitus, Double-Blind Method, Female, Heart Failure, Hospitalization, Humans, Male, Metoprolol, Middle Aged, Risk, Proportional Hazards Models, Survival Analysis, Diabetes Complications
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