Metoprolol in Dilated Cardiomyopathy Trial - MDC

Jan 30, 2002
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Date Published:
01/01/1993
Date Updated:
01/30/2002
Original Posted Date:
01/30/2002
References

Description:

Metoprolol vs. placebo for mortality in dilated cardiomyopathy.

Hypothesis:

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

Exclusions:

Coronary heart disease

Primary Endpoints:

Death or listing for cardiac transplantation

Secondary Endpoints:

Symptoms of heart failure
LVEF

Drug/Procedures Used:

Metoprolol

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).

Interpretation:

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.

References:

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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