Can β-blocker therapy be withdrawn from patients with dilated cardiomyopathy?

Background It has yet to be determined whether withdrawing beta-blocker therapy from patients with dilated cardiomyopathy (DCM) is safe. Methods The influence of tapering and then stopping metoprolol was clarified in 13 patients with DCM who had been receiving this agent for greater than or equal to 30 months. Results seven of the 13 patients deteriorated, including 4 who died suddenly or of congestive heart failure during the 4-month period after metoprolol cessation. Conclusion In patients with DCM in whom beta-blocker therapy is effective, withdrawal of these agents may lead to death. We conclude that beta-blockers should not be stopped in this patient group.