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    Medication Shows Promise for Treating Severe Heart Failure

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    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."

    The findings add to previously reported favorable effects of carvedilol in patients with mild and moderate degrees of heart failure. Additionally, two other drugs in the beta-blocker class, metoprolol and bisoprolol, have been shown to reduce the risk of premature death in patients with mild and moderate heart failure.

    However, Packer cautions against assuming that the COPERNICUS results apply to all beta-blocker medications. Even so, he adds, the favorable results obtained with metoprolol and bisoprolol give physicians at least three choices among beta-blockers for treatment of mild and moderate heart failure.

    The findings from COPERNICUS should encourage physicians to prescribe beta-blockers more often in the treatment of heart failure, says Packer. Prior to COPERNICUS, heart failure authorities estimated that 75-80% of heart failure patients should be receiving a beta-blocker, but available data suggest that no more than 10-20% of heart failure patients are actually prescribed one of these medications.

    "We hope the results of COPERNICUS will not only apply to severe heart failure but will get physicians to bring up the overall percentage of beta-blocker use from where it is now to where it should be," he says.

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