This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wollert, K. C. Articles by Drexler, H. Search for Related Content PubMed PubMed Citation Articles by Wollert, K. C. Articles by Drexler, H. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB CARVEDILOL Medline Plus Health Information Heart Failure Related Collections Congestive Cardiovascular Pharmacology Related Article

(Circulation. 2002;106:2164.)
© 2002 American Heart Association, Inc.

Editorial

Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) Trial

Carvedilol as the Sun and Center of the ß-Blocker World?

Kai C. Wollert, MD; Helmut Drexler, MD

From the Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

Correspondence to Helmut Drexler, MD, Abt. Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625 Hannover, Germany. E-mail drexler.helmut@mh-hannover.de

Key Words: Editorials • heart failure • morbidity • receptors, adrenergic, beta

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Heart failure is a deadly disease that has reached epidemic proportions in industrialized countries. Patients living with heart failure carry a heavy burden in terms of morbidity. Many patients require repeated hospitalizations for cardiovascular problems, especially for episodes of worsening heart failure. In fact, heart failure is one of the most important causes of hospital admissions in the United States, accounting for over 2.5 million admissions per year. Once hospitalized, patients with heart failure have an increased risk of recurrent hospitalizations and death. Approximately 30% to 40% of patients are readmitted within 6 months of an index hospitalization. Angiotensin-converting enzyme (ACE) inhibitors, digitalis, and spironolactone decrease the risk of hospitalization in heart failure patients; however, the annual rate of hospital admission for worsening heart failure has remained high.^1–3

See p 2194

Given these challenges, clinical trials conducted in the mid 1990s that demonstrated that ß-blocker therapy in addition to ACE inhibitors and digitalis reduces the risk of hospitalization in heart failure patients by about 20% to 30% represented remarkable progress. These beneficial effects of ß-blocking agents on morbidity were recognized well before favorable effects on survival were unequivocally established (Table). In some, but not all, trials, the clinical benefits of ß-blocker treatment included improved heart failure symptoms as assessed by physicians and patients.

View this table: [in this window] [in a new window]   Large-Scale Clinical Trials Reporting ß-Blocker Effects on Heart Failure Morbidity

Previous trials addressing the effects of ß-blockers on morbidity have been conducted in patients with mostly mild to moderate heart failure (Table). In . . . [Full Text of this Article]

Related Article:

Effect of Carvedilol on the Morbidity of Patients With Severe Chronic Heart Failure: Results of the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) Study

Milton Packer, Michael B. Fowler, Ellen B. Roecker, Andrew J.S. Coats, Hugo A. Katus, Henry Krum, Paul Mohacsi, Jean L. Rouleau, Michal Tendera, Christoph Staiger, Terry L. Holcslaw, Ildiko Amann-Zalan, David L. DeMets for the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) Study Group
Circulation 2002 106: 2194-2199. [Abstract] [Full Text]

This article has been cited by other articles:

				L. Gao, W. Wang, Y.-L. Li, H. D. Schultz, D. Liu, K. G. Cornish, and I. H. Zucker Simvastatin Therapy Normalizes Sympathetic Neural Control in Experimental Heart Failure: Roles of Angiotensin II Type 1 Receptors and NAD(P)H Oxidase Circulation, September 20, 2005; 112(12): 1763 - 1770. [Abstract] [Full Text] [PDF]

				J. S. Hochman Cardiogenic Shock Complicating Acute Myocardial Infarction: Expanding the Paradigm Circulation, June 24, 2003; 107(24): 2998 - 3002. [Full Text] [PDF]

				R. U. Pliquett, K. G. Cornish, J. D. Peuler, and I. H. Zucker Simvastatin Normalizes Autonomic Neural Control in Experimental Heart Failure Circulation, May 20, 2003; 107(19): 2493 - 2498. [Abstract] [Full Text] [PDF]