CROWD-COMPAREComparison of Carvedilol and Metoprolol Succinate in Heart Failure Patients With Reduced Ejection Fraction

Heart failure with reduced ejection fraction (HFrEF) is a condition that affects 1-2% of adults, increasing to over 10% in people over 70. It significantly reduces life expectancy, physical capacity, and quality of life. The CROWD-COMPARE study aims to compare the effectiveness of two beta-blockers, carvedilol and metoprolol succinate, in treating HFrEF. Beta-blockers are recommended for HFrEF patients as they can reduce symptoms, improve heart function, increase physical capacity, and decrease hospitalizations and mortality. However, there's debate over whether all beta-blockers are equally effective or if one is superior. This study is important as it could help clarify this issue and improve treatment for HFrEF patients. In the CROWD-COMPARE study, each participating cardiology department will have four periods: two with carvedilol as the primary beta-blocker and two with metoprolol succinate. The departments will be randomly assigned to start with either carvedilol or metoprolol succinate, then alternate annually. Treatment will follow Danish and European guidelines, with beta-blockers given to patients with symptomatic heart failure and a left ventricular ejection fraction (LVEF) of less than or equal to 40%. The beta-blockers will be increased to the target dose or the maximum tolerated dose. No extra patient visits will be required due to the study. Data will be collected from national registries and linked in anonymous form to hospital admissions, diagnoses, vital status, and other relevant information.