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Judith M. Kramer, MD, MS; Lesley H. Curtis, PhD; Carla S. Dupree, MD, PhD; Adrian F. Hernandez, MD; Mark Massing, MD, PhD; Kevin J. Anstrom, PhD

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In reply

Dr Jolobe's point is well taken. A clear limitation of our population-based study¹ with limited administrative, claims, and outcomes data was our inability to separate those patients with preserved systolic function from those with reduced systolic function. Certainly, the study by Hernandez et al²—demonstrating the lack of benefit of β-blockers in patients with preserved systolic function—highlights the fact that our total population included individuals unlikely to derive a survival benefit from β-blocker therapy. The fact that our population was diluted with potential nonresponders makes it even more striking that we were able to demonstrate a survival advantage of both evidence-based and non–evidence-based β-blockers compared with no β-blocker therapy.

Dr Jolobe's vision of personalized medicine that will identify subsets of patients likely . . . [Full Text of this Article]

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