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comet trial – carvedilol vs metoprolol tartrate, lancet 2003 pubmed abstract the comet trial enrolled 3029 patients Order with heart failure main inclusion criteria symptomatic heart failure nyha class ii – iv with at least one cardiovascular admission in past 2 years; ef 35 ; receiving ace inhibitor unless contraindicated; receiving diuretic main exclusion criteria receiving nondihydropyridine calcium channel blocker; myocardial infarction, stroke, unstable angina, or revascularization within previous 2 months; sbp 170 or 85; dbp 105; resting pulse 60 bpm; history of asthma or copd baseline characteristics average age 62 years; nyha class ii – 48 , nyha class iii – 48 , nyha class iv – 3 ; average bp – 126 77; average ef – 26 ; medications at enrollment, digoxin – 59 , diuretics – 99 , ace inhibitor – 92 patients were randomized to 1 of 2 groups group 1 1511 patients – carvedilol – target dose 25 mg twice a day group 2 1518 patients – metoprolol tartrate standard-release – target dose 50 mg twice a day carvedilol was started at 6.
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