Consistency of ss-blocker effect across various subgroups with heart failure: insights from the MERIT-HF trial.

Several recently completed survival trials, including Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF), Cardiac Insufficiency Bisoprolol Study II (CIBIS-II), and the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial have examined the effects of ss-blockers on survival and the need for hospitalization. The results from these trials are remarkably consistent regarding reduction of both mortality and hospitalizations for worsening heart failure. MERIT-HF investigated the effect of the lipophilic ss-blocker extended-release metoprolol succinate given once daily in addition to optimum standard therapy in patients with New York Heart Association (NYHA) functional classes II through IV chronic heart failure and ejection fractions of 40% or below. The aim of this article is to review the consistency of ss-blocker effect across various predefined risk groups as well as some post hoc subgroups in MERIT-HF.