B-CONVINCED: Beta-blocker CONtinuation Versus INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode 

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	Presenter | see Discussant report
	Guillaume Jondeau, FESC (France)

List of Authors:

Jondeau G, Neuder Y, Eicher JC, Jourdain P, Fauveau E, Galinier M, Jegou A, Bauer F, Trochu JN, Bouzamondo A, Tanguy ML, Lechat P, for the B-CONVINCED investigators
Abstract:

Whether or not beta-blocker therapy should be stopped during acutely decompensated heart failure (ADHF) is unsure.

In a randomised, controlled, open label, non inferiority trial, we compared beta-blockade continuation versus discontinuation during ADHF in patients with LVEF below 40% previously receiving stable beta-blocker therapy. 169 patients were included, among which 147 were evaluable. Mean age was 72±12 years, 65% were males.
After 3 days, 92.8% of patients pursuing beta-blockade improved for both dyspnea and general well being according to a physician blinded for therapy vs. 92.3% of patients stopping beta-blocker. This was the main end point and the upper limit for unilateral 95% CI for the difference (6.6%) is lower that the predefined upper limit (12.5%), indicating non-inferiority. Similar findings were obtained at 8 days and when evaluation was made by the patient. Plasma BNP at day 3, length of hospital stay, re-hospitalisation rate and death rate after 3 months were also similar. Beta-blocker therapy at 3 months was given to 90% of patients vs. 76% (p<0.05).

During ADHF, continuation of beta-blocker therapy is not associated with delayed or lesser improvement, but with a higher rate of chronic prescription of beta-blocker therapy after 3 months, the benefit of which is well established.

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	Discussant | see Presenter abstract
	Karl Swedberg, FESC (Sweden)

Report:

Notes to editor
This congress report accompanies a presentation given at the ESC Congress 2009. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.