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Medication Shows Promise for Treating Severe Heart Failure

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Sept. 11, 2000 (Boca Raton, Fla.) -- Results from a large study of the heart medication carvedilol are encouraging for patients suffering from severe heart failure. In the study, heart failure patients who were treated with carvedilol had a 35% lower risk of dying from their illness compared to patients who didn't receive the drug. In fact, carvedilol's positive effects were so apparent that the researchers stopped their study a year before its expected completion date.

"If you look at the data from this study and calculate the public health impact, calculate the effect of carvedilol in patients like the ones in this study, this treatment probably has one of the greatest public health impacts we have had in cardiovascular medicine," Milton Packer, MD, tells WebMD.

Heart failure occurs when the heart is unable to pump enough blood to get enough oxygen and other nutrients throughout the body. It can have multiple causes, such as injury to the muscle from a heart attack or even a viral infection of the heart muscle. The medication used in this study, carvedilol, is one of the drugs known as beta-blockers, which are used to treat heart disease.

Carvedilol's benefits applied to all of the patients in the study, regardless of factors such as patient age, gender, ethnicity, or the cause of their heart failure, says Packer, principal researcher in the study and director of the Heart Failure Center at Columbia-Presbyterian Medical Center in New York City.

The international clinical study, called COPERNICUS, involved almost 2,300 patients with the severest forms of heart failure. The patients, who already were receiving all recommended medical treatments for heart failure, were randomly assigned to treatment with carvedilol or a sugar pill. After more than two years of evaluation, patients who received the sugar pills had an annual death rate of 18.5%, while those who were treated with carvedilol had a death rate of 11.4% -- a difference of 35%.

Results from COPERNICUS were initially reported late last month at a cardiology meeting in Amsterdam. The findings will be reported for the first time in the United States later this week.

Putting the results into perspective, Packer points out that even therapies proven to reduce the risk of heart disease, such as drugs that lower cholesterol or blood pressure, typically require treatment of large numbers of patients for long periods of time to show any benefit for the medications. For example, between 50 and 100 heart failure patients would have to be treated for a year with a typical heart failure medication in order to save one life.

"In COPERNICUS, we had to treat 14 patients for 1 year with carvedilol to save one life," says Packer. "We have hardly ever seen a drug that has that kind of potential impact on public health. If you took the results of COPERNICUS and [applied] them to all patients with severe heart failure, ... we would be saving about 50,000 lives a year in the U.S. We don't have too many therapies that can do that."

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