β-blocker treatment and risk prediction in heart failure

The impact of beta-blocker treatment on the value of currently used prognostic parameters was investigated in 408 patients with congestive heart failure (CHF), who were followed over one year. A beneficial effect of beta-blocker treatment on the combined endpoint (worsening CHF or cardiac death) was seen throughout the total study population, but was most obvious in more advanced stages of CHF, i.e. patients with a peakVO(2) <10 ml/min/kg, a LVEF <20% and/or plasma concentrations of norepinephrine (NE) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in the highest tertile. Therefore, a re-evaluation of current criteria for risk stratification in CHF might be warranted in patients treated with beta-blockers.