The incomplete Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT)

• Published in: European journal of heart failure Vol. 4; no. 4; pp. 495 - 499
• Main Authors: Torp-Pedersen, Christian, Køber, Lars, Ball, Stephen, Hall, Alistair, Brendorp, Bente, Ottesen, Michael Mundt, Berning, Jens, Jensen, Gorm, Hampton, John, Zilles, Peter, Eberle, Siegfried, Carlsen, Jan
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.08.2002
• Subjects: Adrenergic beta-Antagonists - adverse effects; Adrenergic beta-Antagonists - therapeutic use; Adult; Aged; Aged, 80 and over; beta-blockerBucindololHeart failure; Drug Therapy, Combination; Female; Heart Failure - drug therapy; Heart Failure - mortality; Heart Failure - physiopathology; Humans; left ventricular dysfunction; Male; Middle Aged; Myocardial Contraction - drug effects; myocardial infarction; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Myocardial Infarction - physiopathology; Propanolamines - adverse effects; Propanolamines - therapeutic use; Survival Rate; Ventricular Dysfunction, Left - drug therapy; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - drug effects
• ISSN: 1388-9842; 1879-0844
• DOI: 10.1016/S1388-9842(02)00032-6

The aim of this study was to evaluate the efficacy of adding the beta‐blocker bucindolol to standard therapy shortly after a myocardial infarction in a high‐risk population with reduced left ventricular function. Methods The study was planned to include 2000 patients with an enzyme confirmed myocardial infarction and severely reduced left ventricular function determined by echocardiography (corresponding to ejection fraction ≤0.35). The primary endpoint was all cause mortality and the secondary endpoints were time to first event of death, progression of heart failure or reinfarction—and the components. The study was closed early due to discontinuation of development of bucindolol by the manufacturer. Therefore, 170 patients were randomised to receive bucindolol and 173 to receive placebo. Results There were 27 deaths in the bucindolol group and 30 in the placebo group, hazard ratio of bucindolol 0.88 (95% confidence limits 0.5–1.5; P‐0.6). There were 9/4 (bucindolol/placebo, P‐0.16) heart failure events and 5/17 (P‐0.01) reinfarctions in the bucindolol/placebo groups. Conclusion Due to early closure it is unknown whether bucindolol changes mortality in high‐risk post myocardial infarct patients when added to best medical therapy. The frequency of reinfarction was significantly reduced.