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

Abstract

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; Ps0.6). There were 9y4 (bucindololyplacebo, Ps0.16) heart failure events and 5y17 (Ps0.01) reinfarctions in the bucindololyplacebo 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.

Long-Term Prognostic Importance of Diabetes After a Myocardial Infarction Depends on Left Ventricular Systolic Function

“…The current study population comprised Danish patients consecutively screened for entrance in the Trandolapril Cardiac Evaluation (TRACE) study (4), the Danish Investigations of Arrhythmia and Mortality on Dofetilide Myocardial Infarction (DIAMOND-MI) study (5), and the Bucindolol Evaluation in Acute MI Trial (BEAT) study (6). Full study designs have been described previously (4–6).…”

“…Full study designs have been described previously (4–6). In brief, departments participating in any of the studies were required to screen consecutive patients admitted with acute MI.…”

Heart Rate Versus Heart Rate Variability in Risk Prediction after Myocardial Infarction

“…From June 1998 to August 1999, 481 consecutive patients admitted with an acute MI were examined by echocardiography and 24‐hour Holter monitoring. Patients were recruited from five centers, and the study was performed during the screening phase of the B ucindolol E valuation in A cute Myocardial Infarction T rial (BEAT) 7 . Forty‐nine patients eventually participated in the BEAT study.…”

Epidemiology of heart failure and left ventricular dysfunction after acute myocardial infarction

“…All patients had LVSD (mean LVEF 30%); at randomization, a mean of 2 weeks after AMI, 53% were in Killip class 2 or higher or NHYA class II-IV. More recent studies providing data on HF and LV function after AMI include BEAT, ALIVE, and DIAMOND-MI [24,32,33]. Each of these recruited exclusively patients with LVSD (at ≤ 6 days, 5-21 days and a mean of 3 days, respectively, after AMI) and reported clinical and/or radiologic HF in 55.5%, 53%, and 89% at randomization, respectively.…”