6/28/23, 11:16 PM MERIT-HF Pathway Feedback Search Clinical Topics Home Studies MERIT HF MERIT HF Disease Heart failure Trial question Is conventional therapy plus metoprolol CR/XR once daily superior to conventional therapy alone in patients with HF, a LVEF 40%, and NYHA class II-IV symptoms? Study design Multi-center Double blinded RCT Population Characteristics of study participants 35.4% female N = 3991 64.6% male 3991 patients (898 female, 1693 male) Inclusion criteria: patients with HF, an LVEF 40%, and NYHA class II-IV symptoms Key exclusion criteria: acute myocardial infarction or unstable angina within 28 days before randomization; indication or contraindication for treatment with beta blockers, HF secondary to systemic disease or alcohol abuse; or AV block of the second and third degree Interventions N=1990 conventional therapy plus metoprolol CR/XR once daily (12.5 mg for NYHA III-IV or 25.0 mg once daily for NYHA II, target dose 200 mg once daily plus optimum standard therapy) N=2001 placebo (conventional therapy alone) https://web.pathway.md/studies/rechlJN240XGynIFR 1/2 6/28/23, 11:16 PM MERIT-HF Pathway Primary outcome All-cause death 11.0 % 11 8.3 % 7.2 5.5 % Significant decrease 2.8 % NNT = 26 0.0 % Conventional therapy plus metoprolol CR/XR once daily Placebo Significant decrease in all-cause death (7.2% vs. 11%; RR 0.66, 95% CI 0.53 to 0.81) Secondary outcomes Significant decrease in sudden cardiac death (0.19% vs. 0.132%; RR 0.59, 95% CI 0.28 to 0.9) Significant decrease in worsening HF (0.3% vs. 0.58%; RR 0.51, 95% CI 0.33 to 0.79) Conclusion In patients with HF, an LVEF 40%, and NYHA class II-IV symptoms, conventional therapy plus metoprolol CR/XR once daily was superior to placebo with respect to a all-cause death. Reference MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999 Jun 12;353(9169):2001-7. Open reference URL https://web.pathway.md/studies/rechlJN240XGynIFR 2/2