| pathology | Demonstrated benefit and harm | k | | | |
|---|
| acute myocardial infarction | versus placebo or control No demonstrated result for efficacy | 9 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| MIAMI Trial Research Group , 1985 | vs placebo | | | all cause death 0.87 [0.69; 1.11] | | Von Essen , 1982 | vs placebo | | | all cause death 1.04 [0.07; 15.74] | | Waagstein , 1975 | Practololormetoprolol vs placebo | | | all cause death NaN [NaN; NaN] | | TIMI IIB, 1989 | vs placebo | | | all cause death 1.00 [0.51; 1.94] | | Hjalmarson , 1981 | Metoprolol vs placebo | all cause death 0.64 [0.44; 0.95] reinfarction 0.65 [0.43; 0.98] | | | | LIT Research Group , 1987 | Metoprolol vs placebo | | | all cause death 0.93 [0.70; 1.23] cardiovascular death 0.93 [0.69; 1.26] Sudden death 0.85 [0.48; 1.49] cardiac death 0.98 [0.72; 1.32] | | Manger Cats , 1983 | Metoprolol vs placebo | | | all cause death 0.58 [0.26; 1.28] | | Rehnqvist , 1983 | Metoprolol vs placebo | reinfarction 0.55 [0.32; 0.95] | | all cause death 0.77 [0.48; 1.24] | | Salathia , 1985 | Metoprolol vs placebo | Sudden death 0.41 [0.18; 0.93] | | all cause death 0.79 [0.55; 1.13] cardiac death 0.84 [0.57; 1.25] |
| Trial | Treatments | Patients | Method |
|---|
| MIAMI Trial Research Group , 1985 | Metoprolol (initial dose intravenously) (n=2877) vs. (n=2901) | |
Double Sample size: 2877/2901 Primary endpoint: FU duration: 15 days | | Von Essen , 1982 | Metoprolol (initial dose intravenously) (n=25) vs. (n=26) | |
Double Sample size: 25/26 Primary endpoint: FU duration: 14 days | | Waagstein , 1975 | Practolol, (initial dose intravenously) H87/07, or metoprolol (n=38) vs. (n=45) | |
Double Sample size: 38/45 Primary endpoint: FU duration: 1 week | | TIMI IIB, 1989 | Metoprolol (initial dose intravenously) (15 mg) (n=696) vs. (n=694) | |
No Sample size: 696/694 Primary endpoint: FU duration: 5 days | | Hjalmarson , 1981 | Metoprolol 100mg twice daily (initial dose intravenously) (n=698) vs. placebo (n=697) | patients aged between 40 -74 years with suspected MI and onset of infarction within the previous 48h | Double blind Parallel groups Sample size: 698/697 Primary endpoint: all cause death FU duration: 2 years | | LIT Research Group , 1987 | Metoprolol 100 mg bid (n=1195) vs. placebo (n=1200) treatment continued for up to 1 year | patients, 45 to 74 yearsof age, surviving a recent acute MI | Double blind Parallel groups Sample size: 1195/1200 Primary endpoint: all-cause mortality FU duration: 18 months | | Manger Cats , 1983 | Metoprolol 100mg twice daily (n=273) vs. placebo (n=280) | MI, NYHA Class I or II and <=70 y | Double blind Parallel groups Sample size: 273/280 Primary endpoint: NA FU duration: 1 year | | Rehnqvist , 1983 | Metoprolol 100mg twice daily (n=154) vs. placebo (n=147) | AMI patients <70 years in sinus rythm without complete BBB | Double blind Parallel groups Sample size: 154/147 Primary endpoint: NA FU duration: 36 months | | Salathia , 1985 | Metoprolol 100 mg twice daily for one year (initial dose intravenously) (n=416) vs. placebo (n=384) | patients with acute myocardial infarction | Double blind Parallel groups Sample size: 416/384 Primary endpoint: NA FU duration: 1 year |
|
| atrial fibrillation | versus placebo or control No demonstrated result for efficacy metoprolol inferior to placebo in terms of Withdrawals due to adverse effects in Kuhlkamp, 2000 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| Kuhlkamp, 2000 | metoprolol vs placebo | | Withdrawals due to adverse effects 3.33 [1.37; 8.12] | all cause mortality ∞ [NaN; ∞] Pro-arrhythmia ∞ [NaN; ∞] Atrial fibrillation recurrence 0.91 [0.79; 1.04] |
| Trial | Treatments | Patients | Method |
|---|
| Kuhlkamp, 2000 | Metoprolol 100 mg/d (n=197) vs. placebo (n=197) | Persistent AF lasting 2 days to 1 year | double blnd Parallel groups Sample size: 197/197 Primary endpoint: FU duration: 6 months |
|
| diabetes type 2 | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| MERIT-HF, 2005 | metoprolol vs placebo | | | All deaths 0.81 [0.57; 1.15] Fatal and nonfatal MI 1.30 [0.69; 2.46] |
| Trial | Treatments | Patients | Method |
|---|
| MERIT-HF, 2005 | metoprolol CR/XL (n=495) vs. placebo (n=490) | patients with CHF NYHA classe 2 to 4 and EF<=40% sub group of diabetic patients | double-blind Parallel groups Sample size: 495/490 Primary endpoint: all-cause death FU duration: 1y |
|
| heart failure | versus placebo or control No demonstrated result for efficacy | 7 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| MDC (Waagstein), 1993 | metoprolol vs placebo | | | NYHA deterioration 0.87 [0.34; 2.20] all cause death 1.07 [0.61; 1.86] death or HF hospitalisation 0.77 [0.56; 1.06] hospitalisation for heart failure 0.74 [0.50; 1.07] NYHA improvement 1.26 [0.93; 1.70] | | MERIT-HF, 1999 | metoprolol vs placebo | all cause death 0.67 [0.55; 0.82] cardiovascular death 0.63 [0.51; 0.78] Sudden death 0.60 [0.46; 0.79] | | | | Engelmeier, 1985 | metoprolol vs placebo | | | | | Fisher, 1994 | metoprolol vs placebo | | | | | Eichhorn, 1994 | metoprolol vs placebo | | | | | RESOLVD, 2000 | metoprolol vs placebo | | | | | BEST (elderly subgroup), 2001 | Metoprolol vs placebo | | | All cause death 0.91 [0.75; 1.11] |
| Trial | Treatments | Patients | Method |
|---|
| MDC (Waagstein), 1993 | metoprolol target dose 100-150 mg daily (dose divided into two or three per day) (n=194) vs. placebo (n=189) | patient with heart failure due to idiopathic dilated cardiomyopathy (NYHA 1-3) and EF<40% | Double blind Parallel groups Sample size: 194/189 Primary endpoint: death or transplantation waiting list FU duration: 18 months | | MERIT-HF, 1999 | metoprolol CR/XL at target dose of 200 mg once daily (n=1990) vs. placebo (n=2001) | patients with chronic heart
failure in New York Heart Association (NYHA) functional class II–IV and with ejection fraction of 0·40 or less, stabilised with optimum standard therapy | Double blind Parallel groups Sample size: 1990/2001 Primary endpoint: all-cause death FU duration: 1 y | | Engelmeier, 1985 | metoprolol (n=9) vs. placebo (n=16) | NYHA 2-4, IDC | Sample size: 9/16 Primary endpoint: Exercise tolerance FU duration: 12 mo | | Fisher, 1994 | metoprolol (n=25) vs. placebo (n=25) | NYHA 3-4, CAD | Sample size: 25/25 Primary endpoint: Exercise tolerance FU duration: 6 mo | | Eichhorn, 1994 | metoprolol (n=15) vs. placebo (n=9) | NYHA 2-3, IDC | Sample size: 15/9 Primary endpoint: Hemodynamics FU duration: 3 mo | | RESOLVD, 2000 | metoprolol CR 200 mg/d (n=214) vs. placebo (n=212) | CHF of mixed causes, patients with symptomatic CHF(NYHA II to IV), a 6-minute walk distance of <500 m, and an LV ejection fraction (EF) of<40% | Double aveugle Parallel groups Sample size: 214/212 Primary endpoint: FU duration: 6 mo | | BEST (elderly subgroup), 2001 | Metoprolol (n=1092) vs. placebo (n=0) | Upper tertile age | Sample size: 1092/0 Primary endpoint: FU duration: |
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