Comparison of Treatment Initiation with Bisoprolol Vs. Enalapril in Chronic Heart Failure Patients: Rationale and Design of CIBIS-III

Abstract

If the trial shows non-inferiority for bisoprolol-first vs. enalapril-first, the first CHF therapy may be chosen based on individual judgement in each patient. If bisoprolol-first is superior to enalapril-first, a beta-blocker should be given prior to an ACE-inhibitor in CHF, and the paradigm of testing CHF compounds against a background of ACE-inhibitor therapy will be challenged.