Results from COMET show a significant improvement in survival for carvedilol over metoprolol

The COMET trial, which began in 1996 took place in 341 centres across 15 European countries and enrolled 3029 patients. Patients were randomized to carvedilol or metoprolol tartrate. The trial was conducted to establish whether differences between carvedilol and metoprolol would translate into differences in mortality and morbidity in patients with moderate and severe chronic heart failure. Metoprolol has a high specificity for the beta-1 receptor, while carvedilol blocks beta-1 and beta-2 receptors and inhibits alpha-1 adrenergic receptors. The antioxidant properties of Carvedilol have been suggested to have beneficial effects on endothelial dysfunction and apoptosis, mechanisms that could be important in the progression of chronic heart failure. These additional properties have led to speculation that carvedilol could be more effective than other beta-blockers in the treatment of heart failure.Commenting on the COMET results, Professor Philip Poole-Wilson, Chairman of the COMET Steering Committee said: "COMET is the longest and largest study ever conducted in chronic heart failure with more than 10,000 patient years of follow-up. The significant survival benefits of carvedilol demonstrate a clear difference between the agents." The principal results of COMET will be presented in detail at the Heart Failure 2003 meeting organized by the European Society of Cardiology, June 21-24, in Strasbourg, France.Reference...