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Am J Cardiol. 2004 May 6;93(9A):40B-2B.

Commentary on the Carvedilol or Metoprolol European Trial (COMET).

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  • 1National Heart and Lung Institute and Faculty of Medicine, Imperial College London, London, United Kingdom.


beta-Adrenergic blockade is commonly and successfully used to treat chronic heart failure. Until recently, few data were available on which to base selection of a particular beta-blocking agent. The Carvedilol or Metoprolol European Trial (COMET) provides evidence that beta-blockers are not interchangeable. The trial compared carvedilol, a nonselective beta-blocker with alpha-adrenergic blocking and numerous ancillary activities, with metoprolol tartrate. In comparison to metoprolol tartrate, significant reductions in all-cause mortality and cardiovascular mortality were observed with carvedilol. These data indicate that cardiovascular benefit may be obtained from switching patients from metoprolol tartrate to carvedilol.

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