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.

Study Design

Study Design:

Patient Populations:

Clinical congestive heart failure
Diagnosis of cardiomyopathy


Coronary heart disease

Primary Endpoints:

Death or listing for cardiac transplantation

Secondary Endpoints:

Symptoms of heart failure

Drug/Procedures Used:


Principal Findings:

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

Clinical Topics: Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Cardiac Surgery and Heart Failure, Acute Heart Failure, Heart Transplant

Keywords: Follow-Up Studies, Heart Failure, Metoprolol, Cardiomyopathy, Dilated, Heart Transplantation

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