Metoprolol in Dilated Cardiomyopathy Trial - MDC
Metoprolol vs. placebo for mortality in dilated cardiomyopathy.
Metoprolol will reduce mortality and morbidity in patients with heart failure due to cardiomyopathy rather than coronary heart disease.
Clinical congestive heart failure
Diagnosis of cardiomyopathy
Coronary heart disease
Death or listing for cardiac transplantation
Symptoms of heart failure
During the double-blind part of the study (mean follow-up time 14 months), there was a 34% reduction in the primary endpoint: death or need for cardiac transplantation (p=0.058).
Three years after randomization, 39 of the patients originally randomized to placebo had died, compared with 35 deaths in those randomized to metoprolol. One death in the placebo group and three in the metoprolol group had occurred after cardiac transplantation. Three years after randomization, cardiac transplantation had been done in 16 patients randomized to placebo and in seven randomized to metoprolol (p=0.035).
This study adds to the growing portfolio suggesting beta blockers in a wide range of heart failure patients are beneficial. The major weakness of the study was the combined primary endpoint. Metoprolol was well tolerated in this patient population.
1. Lancet 1993;342:1441-1446. Final results (14 months)
2. Cardiovascular Drugs & Therapy 1996;10:361-8. Quality of life
3. Lancet 1998; 351:1180-1. 3-year follow-up
Keywords: Follow-Up Studies, Heart Failure, Metoprolol, Cardiomyopathy, Dilated, Heart Transplantation
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