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European Journal of Heart Failure 1999 1(2):197-200; doi:10.1016/S1388-9842(99)00022-7
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© 1999 European Society of Cardiology

Update of REACH-1 and MERIT-HF clinical trials in heart failure

On behalf of the Cardio.net Editorial Team, Panayiota Mylona* and John G.F. Cleland

Cardio.net Editorial Office First Floor, Sovereign Court, King Edward Street, Macclesfield, Cheshire, SK10 1AA, UK

* Corresponding author.


  Abstract

Background: This article reviews the design and results of REACH-1 (Research on Endothelin Antagonism in Chronic Heart Failure) and MERIT (Metoprolol controlled and Extended release, Randomised Intervention Trial in congestive Heart Failure), two recently reported clinical trials that investigated, respectively, the role of a non-selective endothelin antagonist (bosentan) and of a β-selective blocker for the treatment of heart failure. Results: The REACH-1 trial demonstrated that initiation of bosentan therapy is associated with an increased risk of worsening heart failure. However, long-term therapy with bosentan may have improved symptoms and favourably altered the progression of heart failure. The MERIT-HF clinical trial indicated that β-blockade using metoprolol confers a significant beneficial effect on total mortality in patients with stable chronic heart failure.

Key Words: Heart failure • Clinical trial • Endothelin antagonists • Bosentan • β-Blockers • Metoprolol

Accepted April 13, 1999


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