P&S Journal: Fall 1996, Vol.16, No.3
Carvedilol for Congestive Heart Failure
Adding the drug carvedilol to the standard treatment for congestive heart failure can reduce the risk of death by 65 percent, according to a study published in a May issue of the New England Journal of Medicine. The study was carried out at CPMC and four other medical centers.
The double-blind study randomly assigned 1,094 patients with chronic heart failure to receive either a placebo or the beta-blocker carvedilol. All patients also received background therapy with digoxin, diuretics, and an angiotensin-converting-enzyme inhibitor. The study monitored the effects of carvedilol on cardiovascular-related hospitalization and death rates.
Compared with subjects receiving a placebo, subjects in the carvedilol group had a 65 percent reduction in the risk of death, a 27 percent reduction in the risk of hospitalization for cardiovascular disease, and a 38 percent reduction in the risk of either death or hospitalization. Because of the difference in survival rates, the Data and Safety Monitoring Board halted the trial before its scheduled end.
Prescribing a beta-blocker for congestive heart failure may seem counterintuitive because beta-blockers depress heart function, says Dr. Milton Packer, the Dickinson W. Richards Professor of Medicine, professor of pharmacology, and lead author of the study, but the long-term blockade of catecholamine toxicity may preserve cardiac cells and prolong life.
SmithKline Beecham, which makes carvedilol, has applied to the U.S. Food and Drug Administration to market the drug for heart failure.