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American Heart Association Comment: Results Of Cardiac Insufficiency Bisoprolol Study II (CIBIS-II)

People with mild to moderate heart failure who were treated with beta-blockers were more likely to survive than individuals who did not receive the drugs, according to a study, CIBIS-II, published in the Jan. 2 issue of Lancet.

Harlan Krumholz, M.D., an American Heart Association spokesperson, who wrote an editorial that accompanied the study, says, "The CIBIS-II trial is an important turning point. Small studies have been accumulating suggesting the value of beta-blockers for patients with heart failure, but this trial provides the first real convincing evidence that patients with mild or moderate heart failure live longer and have less need for hospitalization when treated with beta blockers. Disseminating information about this trial will provide an important public service. We need to get this information to physicians and patients."

In the beta-blocker group there were 34 percent fewer deaths from all causes, and 44 percent fewer sudden deaths. Hospital admissions were 20 percent less among those who received the beta-blocker.

The results of the study suggest that physicians should be using beta-blockers to treat stable patients (someone whose condition is not worsening) with mild to moderate heart failure, first with low doses that should be gradually increased, says Krumholz, associate professor of medicine, Yale School of Medicine.

"The drugs are inexpensive and the benefits are substantial. The message is that we should be looking for opportunities to use these drugs rather than avoid them." Beta-blockers have not been routine drugs for heart failure due to their "depressive" effects on the heart. However, new information about the mechanism of heart failure has led scientists to re-consider the drugs because they may help block the action of some hormones that are released when the heart is damaged.

"These are the same hormones that are released during the 'fight or flight' response and may cause more damage to a weakened h
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Contact: Carole Bullock
caroleb@heart.org
214-706-1279
American Heart Association
31-Dec-1998


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