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NHLBI-VA study finds no increased survival from beta-blocker for moderate to advanced heart failure

A study sponsored by the National Heart, Lung, and Blood Institute (NHLBI) and the Department of Veterans Affairs (VA) found that, overall, the beta-blocker bucindolol did not increase survival for moderate to severe heart failure.

The results also showed racial differences in the drug's effects, although the reasons for these differences are not yet clear. Black heart failure patients received no benefit from bucindolol, while non-black patients treated with the drug lived longer. Non-black patients included whites, Hispanics, Asian/Pacific Islanders, and American Indian/Alaskan Natives. There were no differences by gender in the drug's effects.

The findings of the Beta-Blocker Evaluation of Survival Trial (BEST), which contrast with those of other beta-blocker studies, appear in the May 31 issue of the New England Journal of Medicine.

Other results from BEST are consistent with findings from earlier beta-blocker studies and include: fewer deaths from cardiovascular disease, fewer and shorter hospitalizations for heart failure, and fewer deaths or heart transplants for those treated with bucindolol, compared to the placebo.

"The results from BEST offer physicians valuable added guidance about the use of beta-blockers for heart failure," said NHLBI Director Dr. Claude Lenfant. "Its results also underscore the need to examine gender, racial, and ethnic differences in future studies of cardiovascular disease."

"Based on the large amount of evidence of benefit of beta-blockers from previous studies, beta-blockers should be considered for all heart failure patients at this time, including African American patients. However, further research is needed in this population," said BEST Co-Chair Dr. Eric Eichhorn of the Dallas VA Medical Center.

"In BEST, there was a trend toward longer survival for study participants treated with bucindolol who had less advanced heart failure," said Dr. Michael Domanski, Leader of NHLBI's Clinical Trials Scientif
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Contact: NHLBI Communications Office
301-496-4236
NIH/National Heart, Lung, and Blood Institute
30-May-2001


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