Carvedilol Inhibits Clinical Progression in Patients With Mild Symptoms of Heart Failure

Colucci, Wilson S.; Packer, Milton; Bristow, Michael R.; Gilbert, Edward M.; Cohn, Jay N.; Fowler, Michael B.; Krueger, Steven K.; Uretsky, Barry F.; Bowers, John; Sackner‐Bernstein, Jonathan; Young, Sarah; Holcslaw, Terry L.; Lukas, Mary Ann

doi:10.1161/01.cir.94.11.2800

Cited by 562 publications

(292 citation statements)

References 24 publications

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“…However, exercise tolerance has not been consistently improved with carvedilol in clinical trials in heart failure,28, 29, 30 and treatments that have improved symptoms and exercise tolerance have not produced striking effects on cachexia.…”

Section: Discussionmentioning

confidence: 99%

Effect of beta‐adrenergic blockade with carvedilol on cachexia in severe chronic heart failure: results from the COPERNICUS trial

Clark

Coats

Krum

et al. 2017

J cachexia sarcopenia muscle

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BackgroundCardiac cachexia frequently accompanies the progression of heart failure despite the use of effective therapies for left ventricular dysfunction. Activation of the sympathetic nervous system has been implicated in the pathogenesis of weight loss, but the effects of sympathetic antagonism on cachexia are not well defined.MethodsWe prospectively evaluated changes in body weight in 2289 patients with heart failure who had dyspnoea at rest or on minimal exertion and a left ventricular ejection fraction <25%. Patients were randomly assigned (double‐blind) to receive either placebo (n = 1133) or carvedilol (n = 1156) and were followed for the occurrence of major clinical events for up to 29 months (COPERNICUS trial). Patients were not enrolled if they had signs of clinically significant fluid retention due to heart failure.ResultsPatients in the carvedilol group were 33% less likely than patients in the placebo group to experience a further significant loss of weight (>6%) (95% confidence interval: 14–48%, P = 0.002) and were 37% more likely to experience a significant gain in weight (≥5%) (95% confidence interval: 12–66%, P = 0.002). Carvedilol's ability to prevent weight loss was most marked in patients with increased body mass index at baseline, whereas its ability to promote weight gain was most marked in patients with decreased body mass index at baseline. Increases in weight were not accompanied by evidence of fluid retention. Baseline values for body mass index and change in body weight were significant predictors of survival regardless of treatment.ConclusionsCarvedilol attenuated the development and promoted a partial reversal of cachexia in patients with severe chronic heart failure, supporting a role for prolonged sympathetic activation in the genesis of weight loss.

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Section: Discussionmentioning

confidence: 99%

Effect of beta‐adrenergic blockade with carvedilol on cachexia in severe chronic heart failure: results from the COPERNICUS trial

Clark

Coats

Krum

et al. 2017

J cachexia sarcopenia muscle

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“…All of these drugs have been shown or strongly suggested to improve outcomes in CHF.i-3,9-12,14-1*, 24. [34][35][36][37][38][39][40][41][42][43][44][45] There are other reasons for the superior outcomes at specialized programs: they include the comprehensive preventive nature of the care, based on frequent evaluation and close interaction with specialized experienced staff. 46 This often results in the identification of problems at early stages.…”

Section: Discussionmentioning

confidence: 99%

Effect of Heart Failure Program on Cardiovascular Drug Utilization and Dosage in Patients with Chronic Heart Failure

Ramahi

Longo

Rohlfs

et al. 2000

Clinical Cardiology

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SummaryBackground: Utilization and dosage of angiotensin-converting enzyme (ACE) inhibitors in patients with chronic heart failure (CHF) remain low. Recent data suggest that care of patients with CHF in specialized heart failure programs is associated with improved clinical outcomes.Hypothesis: Specialized heart failure care is associated with better utilization and higher dose of cardiovascular drugs.Methods: Data from 133 patients with CHF referred to a heart failure program were analyzed. Mean functional class

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“…This conclusion can be drawn from the results of multicenter studies that showed an improvement of the hemodynamic parameters and reduction of mortality due to the use of drugs that block beta-adrenergic receptors [73][74][75][76][77][78] . Opposite results were obtained with agonists of these receptors [79][80][81] .…”

Section: Neurohormonal Systemmentioning

confidence: 99%

Prognostic factors in patients with congestive heart failure

Villacorta¹,

Mesquita²

1999

Arq. Bras. Cardiol.

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Carvedilol Inhibits Clinical Progression in Patients With Mild Symptoms of Heart Failure

Abstract: Carvedilol, when added to standard therapy, including an ACE inhibitor, reduces clinical progression in patients who are only mildly symptomatic with well-compensated heart failure.

Cited by 562 publications

References 24 publications

Effect of beta‐adrenergic blockade with carvedilol on cachexia in severe chronic heart failure: results from the COPERNICUS trial

Effect of beta‐adrenergic blockade with carvedilol on cachexia in severe chronic heart failure: results from the COPERNICUS trial

Effect of Heart Failure Program on Cardiovascular Drug Utilization and Dosage in Patients with Chronic Heart Failure

Prognostic factors in patients with congestive heart failure

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