Carvedilol Cuts Congestive Heart Failure Admissions by 20% - Brief Article

0 Comments | Family Practice News, April 15, 2001 | by Bruce Jancin

ORLANDO, FLA. -- Carvedilol therapy reduced all hospitalizations by 20% in patients with severe congestive heart failure, according to new findings from a landmark trial.

The Carvediol Prospective Randomized Cumulative Survival (COPERNICUS) trial was a randomized, double-blind trial involving 2,289 patients with stabilized class IV congestive heart failure (CHF) and left ventricular ejection fractions below 25%. Last year, investigators announced that the study had been halted early for ethical reasons because the carvedilol arm had shown a 35% reduction in all-cause mortality compared with placebo.

What's new in COPERNICUS are the secondary end point findings involving hospital utilization. Patients treated with carvedilol had 28% fewer hospitalizations for a cardiovascular reason and 33% fewer admissions for heart failure, Dr. Milton Packer reported at the annual meeting of the American College of Cardiology.

The carvedilol group also spent 27% fewer total days in the hospital for any reason than those in the placebo group. And while in the hospital, carvedilol-treated patients required fewer intravenous treatments for heart failure and fewer echocardiographic evaluations of their ventricular function. Thus, carvedilol reduced not only the frequency but also the severity of hospitalizations, said Dr. Packer, chair of the COPERNICUS steering committee and director of the heart failure research center at Columbia-Presbyterian Medical Center, New York.

Participants in COPERNICUS were already on an ACE inhibitor and other standard CHF drugs. Many were enrolled while hospitalized for worsening heart failure, although patients were ineligible if they were in the intensive care unit or if they had received intravenous vasodilators or inotropes within 4 days.

He noted that there has been a wealth of positive clinical trial data, yet utilization of [beta]-blockers in CHF remains very low in the United States.