Which β-Blocker for Heart Failure?

Several β-blocking medications, including bisoprolol, long-acting metoprolol succinate, and carvedilol, reduce mortality in heart failure patients. In a study that was supported by the makers of carvedilol, European investigators randomized 3029 patients (mean age, 62) to receive either carvedilol (target dose, 25 mg twice daily) or metoprolol tartrate (target dose, 50 mg twice daily) in addition to standard therapy with diuretics and angiotensin-converting-enzyme inhibitors.

After an average follow-up of 58 months, the all-cause mortality rate was 34% in the carvedilol group and 40% in the metoprolol group -- a significant difference. The composite endpoint of mortality and all-cause hospital admission was not significantly different betwee…