Recent clinical data regarding the use of β blockers in heart failure: focus on CIBIS Ⅱ

摘要

From studies which first started in Sweden many years ago, the evidence for the beneficial role of β blockers in the management of heart failure is now very substantial. We have considerable data from the meta-analyses of many small trials and from the second cardiac insufficiency bisoprolol study (CIBIS Ⅱ). The modern era of large randomised control trials involving β blockers really started with the US carvedilol heart failure study, in which a very substantial reduction in mortality (which was not the primary aim of the study programme) and morbidity was shown with carvedilol. Another study with carvedilol was the smaller Australia-New Zealand heart failure research group trial of around 300 patients following myocardial infarction. This showed a reduction in a composite end point of hospitalisa-tions but focused on one aspect—the effect on left ventricular function—which suggested that it was improved by carvedilol. This effect has now become an important feature of β blocker treatment.