The Beta-Blocker Evaluation of Survival Trial Investigators (BEST)

Objectives:

The Beta-Blocker Evaluation of Survival Trial was designed to determine whether bucindolol hydrochloride- a nonselective beta-adrenergic blocker and mild vasodilator- would reduce the rate of death from any cause among patients with advanced heart failure and to assess its effects in various subgroups defined by ethnic background and demographic criteria- specifically women and members of minority groups.

Background:

Although beta-adrenergic-receptor antagonists reduce morbidity and Mortality in patients with mild-to-moderate chronic heart failure, their effort on survival in patients with more advanced heart failure is unknown.

Subjects:

A total of 2,708 patients with heat failure and a left ventricular ejection fraction of 35 percent or lower were randomly assigned to double-blind treatment with either bucindolol (1,354 patients) or placebo (1,354 patients) and followed for the primary end point of death from any cause.

Conclusions:

Bucindolol resulted in no significant overall survival benefit. (N Engl J Med 2001;344:1659-67)