Which of the following beta-blockers has not been shown to improve mortality in heart failure patients?

Which of the following beta-blockers has not been shown to improve mortality in heart failure patients?

• A. Bisoprolol
• B. Atenolol
• C. Carvedilol
• D. Metoprolol succinate

Answer: (B)

In heart failure with reduced ejection fraction, certain beta-blockers have been shown to reduce death and hospitalizations by dampening the harmful effects of chronic sympathetic activation on the heart. The strongest evidence comes from three large trials: bisoprolol reduced mortality in CIBIS-II, carvedilol reduced mortality in COPERNICUS, and metoprolol succinate reduced mortality in MERIT-HF. Atenolol, while it can improve symptoms and some hemodynamic measures, did not demonstrate a mortality benefit in major heart failure trials. This is why atenolol is not considered proven to improve survival in heart failure, unlike the other three beta-blockers listed.

In heart failure with reduced ejection fraction, certain beta-blockers have been shown to reduce death and hospitalizations by dampening the harmful effects of chronic sympathetic activation on the heart. The strongest evidence comes from three large trials: bisoprolol reduced mortality in CIBIS-II, carvedilol reduced mortality in COPERNICUS, and metoprolol succinate reduced mortality in MERIT-HF. Atenolol, while it can improve symptoms and some hemodynamic measures, did not demonstrate a mortality benefit in major heart failure trials. This is why atenolol is not considered proven to improve survival in heart failure, unlike the other three beta-blockers listed.