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"Carvedilol or metoprolol succinate" refers to the selection of beta-adrenergic receptor blockers utilized as the primary intervention in the BOAT (Beta Blocker Uptitration With OptiVol After Cardiac Resynchronization Therapy) Phase 4 clinical trial (NCT00433043). This trial, conducted at St. Luke's-Roosevelt Hospital Center, evaluated whether cardiac resynchronization therapy (CRT) could facilitate the uptitration of these specific beta-blockers to their target mortality-reducing doses in patients with heart failure. Carvedilol is a non-selective, third-generation beta-blocker that antagonizes β1, β2, and α1-adrenergic receptors, providing additional vasodilatory effects. Metoprolol succinate is a second-generation, cardioselective β1-adrenergic receptor blocker formulated for extended release. Both medications are standard-of-care therapies for heart failure with reduced ejection fraction (HFrEF), hypertension, and post-myocardial infarction management, having demonstrated significant survival benefits in landmark trials such as COPERNICUS and MERIT-HF.
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