Why the study?
Does beta-adrenergic blockade reduce mortality in patients with advanced heart failure?
Does beta-adrenergic blockade reduce mortality in patients with advanced heart failure?
The COPERNICUS trial extends the known mortality benefits of beta-blockers to patients with more advanced heart failure, though evidence gaps remain for uncompensated, very advanced, and black patients.
May support beta-blocker use in advanced HF; leaves open gaps for uncompensated and subgroup patients.
Previous trials (Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure [MERIT-HF], Cardiac Insufficiency Bisoprolol Study [CIBIS] II) have demonstrated a mortality benefit of beta-adrenergic blockade in patients with mild to moderate heart failure. The recent Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial has extended these results to a more advanced patient population. This trial did not, however, include patients who could not reach compensation, patients with far advanced heart failure symptoms, or a significant number of black patients. Future studies of beta-blockade may focus on these patients or patients with asymptomatic left ventricular dysfunction.
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Eichhorn et al. (2001) studied this question.
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