People keep trying to make metoprolol & COPD a thing. They're not. They don't love each other, they don't hate each other - they're just indifferent to one another. A few years ago there was an overblown trial in NEJM which tried implying that metoprolol *increased* mortality in COPD. I debunked the concept of metoprolol killing people on the blog here: emcrit.org/pulmcrit/metoprol… This new trial will hopefully clarify this topic once and for all. The bottom line on metoprolol & COPD: 🔑 COPD isn't an indication for metoprolol 🔑 COPD isn't a contraindication for metoprolol 🔑 COPD doesn't affect the risk/benefit ratio of metoprolol 🔑 Use metoprolol as indicated for cardiac indications based on the cardiology literature This is actually really simple.

Conference RCT dumps sure are exciting, but here are some tough questions: [1] What are the ethics of embargoing every cardiology RCT for months leading up to the conference? (If this is life-saving information, shouldn't it be released ASAP?) [2] Do you think releasing all of these trials at once improves communication & understanding of them? (Or does it cause the less exciting RCTs to be overlooked?) [3] Do journals & conferences actually improve ethical science communication or just serve their own best interests?