Beta Blocker Aids Patients with Advanced Heart Disease

In an international study involving over 2,200 patients with advanced heart failure, the beta blocking agent Coreg (carvedilol) decreased mortality rates by 35%. Because of this significant survival benefit, the trial was halted earlier this year so that treatment would not be withheld from those who might benefit from it. The results were presented at the 22nd Annual Congress of the European Society of Cardiologists (ESC) in Amsterdam.

The trial, called COPERNICUS, involved more than 300 medical centers in 21 countries. Participants were patients with advanced heart failure who had symptoms at rest or on minimal exertion but not requiring intensive care or intravenous treatments to support heart function. Half of the patients received carvedilol and half a placebo, which were both added to the heart medications already being taken by the patients, such as diuretics, angiotensin-activating enzyme (ACE) inhibitors, and digoxin. Patients were evaluated for up to 29 months. Those treated with Coreg showed a lower mortality rate compared to those treated with placebo (11.4% vs. 18.5%, respectively). Serious adverse effects were more common in the placebo group.

The COPERNICUS trial is so important because the results tell us that carvedilol can reduce the risk of death in a much broader range of patients than we previously thought possible for agents with beta blocking activity, noted Milton Packer, M.D., director of the Heart Failure Center at Columbia University College of Physicians and Surgeons in New York (NY, USA) and chairman of the steering committee of the trial.

Carvedilol is marketed by SmithKline Beecham and Roche Pharmaceuticals. The drug was previously indicated for the treatment of mild or moderate heart failure.