Critical Issues in Peripheral Arterial Disease Detection and Management<subtitle>A Call to Action</subtitle>

Jill J. F. Belch, MD; Eric J. Topol, MD; Giancarlo Agnelli, MD; Michel Bertrand, MD; Robert M. Califf, MD; Denis L. Clement, MD; Mark A. Creager, MD; J. Donald Easton, MD; James R. Gavin III, MD, PhD; Philip Greenland, MD; Graeme Hankey, MD; Peter Hanrath, MD; Alan T. Hirsch, MD; Jurgen Meyer, MD; Sidney C. Smith, MD; Frank Sullivan, PhD; Michael A. Weber, MD; for the Prevention of Atherothrombotic Disease Network

MIC trial: metoprolol in patients with mild to moderate heart failure: effects on ventricular function and cardiopulmonary exercise testing

Beta-blocker therapy results in a functional benefit in patients with heart failure (CHF) due to idiopathic dilated cardiomyopathy (DCM). This study assessed if similar effects were observed in patients with ischemic heart disease (CAD), NYHA II–III after 6 months of therapy with metoprolol. Methods and results: Fifty-two patients with CHF secondary to DCM (26 patients) and CAD (26 patients) and a left ventricular ejection fraction (EF) < 40% were enrolled in the placebo-controlled study. The study medication was titrated over 6 weeks, the mean final dosage was 135 mg/day. Three patients died due to cardiogenic shock, two received placebo and one metoprolol. Eight patients did not complete …

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