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All sufferers who underwent randomization were contained in analyses of the principal and secondary outcomes. Hazard ratios and 95 percent self-confidence intervals were estimated by using stratified Cox proportional-hazards versions. We performed a secondary analysis of the primary outcome using a Cox proportional-hazards model that was modified for the stratification variables, as well as for baseline age group, sex, NYHA functional course, hospitalization for heart failure within 6 months before randomization , diabetes , log serum creatinine level, ejection fraction, reason behind heart failure , body-mass index, remaining bundle-branch block , background of atrial flutter or fibrillation , and systolic blood pressure.