Heart failure patients benefit from the addition of a β-blocker to the standard heart failure regimen.1 The question of which β-blocker yields the greatest effect is still the subject of current research. I would like to provide additional information on β-blockers that was mentioned in “Using Carvedilol to Treat Heart Failure” (April 2002:36–58). The author explained the use of carvedilol in heart failure; however, it is important to mention that there are only 3 β-blockers approved by the Food and Drug Administration (FDA) for use in heart failure: carvedilol (Coreg), metoprolol succinate (Toprol-XL), and bisoprolol (Zebeta).

Like the author suggests, not all β-blockers are the same. Nor is it clear that β-blockers of the same generation are the same. Like carvedilol, bucindolol, a third-generation β-blocker, also sought FDA approval for treatment in heart failure. The BEST trial studied...

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