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Srpski arhiv za celokupno lekarstvo 2005 Volume 133, Issue 5-6, Pages: 242-247
https://doi.org/10.2298/SARH0506242C
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Metoprolol and atenolol in mild-to-moderate chronic heart failure: The comparison of survival benefit

Ćelić Vera (Kliničko-bolnički centar 'Dr Dragiša Mišović' - Dedinje, Klinika za internu medicinu, Beograd)
Penčić Biljana (Kliničko-bolnički centar 'Dr Dragiša Mišović' - Dedinje, Klinika za internu medicinu, Beograd)
Dekleva Milica (Kliničko-bolnički centar 'Dr Dragiša Mišović' - Dedinje, Klinika za internu medicinu, Beograd)
Dimković Siniša (Kliničko-bolnički centar 'Dr Dragiša Mišović' - Dedinje, Klinika za internu medicinu, Beograd)
Kocijančić Maksimilijan (Kliničko-bolnički centar 'Dr Dragiša Mišović' - Dedinje, Klinika za internu medicinu, Beograd)

The clinical end-point of all causes of mortality and cardiovascular hospitalization (combined end-points) is a widely accepted indicator of heart failure survival. The primary aim of this study was to examine the effects of metoprolol and atenool on combined end-points in patients with mild-to-moderate heart failure. This study was designed to be comparative, prospective, and random. The criteria for study inclusion were: age of 70 years or less, New York Heart Association (NYHA) Functional Class II and III, and an ejection fraction of the left ventricle of 40% or less. The patients (a total of 150) on therapy with angiotensin-converting enzyme inhibitor and a diuretic were randomized into three numerically equal therapy groups: 1) an atenolol group; 2) a metoprolol group; and 3) a control group (without beta-blockers). The follow-up period was 12 months. The results were analyzed using: the hisquare test, variance analyses, Kaplan-Meier's model, Wilcox's statistics, and Cox's model. The cumulative survival rate for patients treated with metoprolol was 88%, 78% for patients treated with atenolol, and 48% for patients from the control group. It is clear that the cumulative survival rate for patients treated with metoprolol and atenolol is significantly higher compared to patients from the control group. In addition, the survival rate of patients treated with metoproiol was considerably higher compared to the survival rate of patients treated with atenolol. Metoprolol has significantly reduced the relative risk of combined end-points (71%) compared to atenolol (53%). The results of this comparative study clearly indicate that metoprolol and atenolol have a favorable effect on the survival rate of patients with chronic heart failure. In addition, metoprolol is considerably more effective than atenolol.

Keywords: heart failure, beta-blockers, metoprolol, atenolol, cumulative survival

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