AustralieFrV1, Main, Exploration, bibRecord, 00AC35

Influence of pretreatment systolic blood pressure on the effect of Carvedilol in patients with severe chronic heart failure: The Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) study. Author's reply

Identifieur interne : 00AC35 ( Main/Exploration ); précédent : 00AC34; suivant : 00AC36

Influence of pretreatment systolic blood pressure on the effect of Carvedilol in patients with severe chronic heart failure: The Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) study. Author's reply

Auteurs : Jean L. Rouleau [Canada] ; Ellen B. Roecker [États-Unis] ; Michal Tendera [Pologne] ; Paul Mohacsi [Suisse] ; Henry Krum [Australie] ; Hugo A. Katus [Allemagne] ; Michael B. Fowler [États-Unis] ; Andrew J. S. Coats [Australie] ; Alain Castaigne [France] ; Armin Scherhag [Suisse] ; Terly L. Holcslaw [États-Unis] ; Milton Packer [États-Unis] ; Jay N. Cohn [États-Unis]

Source :

Journal of the American College of Cardiology [ 0735-1097 ] ; 2004.

RBID : Pascal:04-0355490

Descripteurs français

Pascal (Inist)
- Insuffisance cardiaque, Prétraitement, Pression systolique, Pression sanguine, Pression artérielle, Carvédilol, Homme, Grave, Chronique, Prospective, Essai clinique, Randomisation, Survie, Pronostic, Appareil circulatoire, Cardiologie, Phlébologie, Antihypertenseur, Vasodilatateur.
Wicri :
- topic : Homme, Prospective.

English descriptors

KwdEn :
- Antihypertensive agent, Arterial pressure, Blood pressure, Cardiology, Carvedilol, Chronic, Circulatory system, Clinical trial, Heart failure, Human, Phlebology, Pretreatment, Prognosis, Prospective, Randomization, Severe, Survival, Systolic pressure, Vasodilator agent.

Abstract

OBJECTIVES We sought to evaluate the influence of pretreatment systolic blood pressure (SBP) on the efficacy and safety of carvedilol in patients with chronic heart failure (CHF). BACKGROUND Although beta-blockers reduce the risk of death in CHF, there is little reported experience with these drugs in patients with a low pretreatment SBP, who may respond poorly to beta-blockade. METHODS We studied 2,289 patients with severe CHF who participated in the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial. RESULTS Compared with placebo, carvedilol improved the clinical status and reduced the risk of death and the combined risk of death or hospitalization for any reason, for a cardiovascular reason, or for worsening heart failure (p < 0.001 for all). The relative magnitude of these benefits did not vary as a function of the pretreatment SBP (all interaction: p > 0.10). However, because patients with the lowest SBP were at highest risk of an event, they experienced the greatest absolute benefit from treatment with carvedilol. The lower the pretreatment SBP, the more likely that patients would report an adverse event, be intolerant of high doses of the study drug, or require permanent withdrawal of treatment (p < 0.001 for all). However, these risks were primarily related to the severity of the underlying illness and not to treatment with carvedilol. CONCLUSIONS The current study provides little support for concerns about using beta-blockers (particularly those with vasodilatory actions) in patients with severe CHF who have a low SBP. Pretreatment blood pressure can identify patients who have the greatest need for risk reduction with carvedilol.

Affiliations:

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Le document en format XML

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<author><name sortKey="Scherhag, Armin" sort="Scherhag, Armin" uniqKey="Scherhag A" first="Armin" last="Scherhag">Armin Scherhag</name>
<affiliation wicri:level="1"><inist:fA14 i1="10"><s1>F. Hoffmann-La. Roche Ltd.</s1>
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<s2>New York, New York</s2>
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<placeName><region type="state">État de New York</region>
<settlement type="city">New York</settlement>
</placeName>
<orgName type="university">Université Columbia</orgName>
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<author><name sortKey="Cohn, Jay N" sort="Cohn, Jay N" uniqKey="Cohn J" first="Jay N." last="Cohn">Jay N. Cohn</name>
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<series><title level="j" type="main">Journal of the American College of Cardiology</title>
<title level="j" type="abbreviated">J. Am. Coll. Cardiol.</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antihypertensive agent</term>
<term>Arterial pressure</term>
<term>Blood pressure</term>
<term>Cardiology</term>
<term>Carvedilol</term>
<term>Chronic</term>
<term>Circulatory system</term>
<term>Clinical trial</term>
<term>Heart failure</term>
<term>Human</term>
<term>Phlebology</term>
<term>Pretreatment</term>
<term>Prognosis</term>
<term>Prospective</term>
<term>Randomization</term>
<term>Severe</term>
<term>Survival</term>
<term>Systolic pressure</term>
<term>Vasodilator agent</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Insuffisance cardiaque</term>
<term>Prétraitement</term>
<term>Pression systolique</term>
<term>Pression sanguine</term>
<term>Pression artérielle</term>
<term>Carvédilol</term>
<term>Homme</term>
<term>Grave</term>
<term>Chronique</term>
<term>Prospective</term>
<term>Essai clinique</term>
<term>Randomisation</term>
<term>Survie</term>
<term>Pronostic</term>
<term>Appareil circulatoire</term>
<term>Cardiologie</term>
<term>Phlébologie</term>
<term>Antihypertenseur</term>
<term>Vasodilatateur</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
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<front><div type="abstract" xml:lang="en">OBJECTIVES We sought to evaluate the influence of pretreatment systolic blood pressure (SBP) on the efficacy and safety of carvedilol in patients with chronic heart failure (CHF). BACKGROUND Although beta-blockers reduce the risk of death in CHF, there is little reported experience with these drugs in patients with a low pretreatment SBP, who may respond poorly to beta-blockade. METHODS We studied 2,289 patients with severe CHF who participated in the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial. RESULTS Compared with placebo, carvedilol improved the clinical status and reduced the risk of death and the combined risk of death or hospitalization for any reason, for a cardiovascular reason, or for worsening heart failure (p < 0.001 for all). The relative magnitude of these benefits did not vary as a function of the pretreatment SBP (all interaction: p > 0.10). However, because patients with the lowest SBP were at highest risk of an event, they experienced the greatest absolute benefit from treatment with carvedilol. The lower the pretreatment SBP, the more likely that patients would report an adverse event, be intolerant of high doses of the study drug, or require permanent withdrawal of treatment (p < 0.001 for all). However, these risks were primarily related to the severity of the underlying illness and not to treatment with carvedilol. CONCLUSIONS The current study provides little support for concerns about using beta-blockers (particularly those with vasodilatory actions) in patients with severe CHF who have a low SBP. Pretreatment blood pressure can identify patients who have the greatest need for risk reduction with carvedilol.</div>
</front>
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<li>États-Unis</li>
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<region><li>Bade-Wurtemberg</li>
<li>Californie</li>
<li>Canton de Berne</li>
<li>District de Karlsruhe</li>
<li>Minnesota</li>
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<li>Pennsylvanie</li>
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<orgName><li>Université Columbia</li>
<li>Université de Sydney</li>
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<tree><country name="Canada"><region name="Québec"><name sortKey="Rouleau, Jean L" sort="Rouleau, Jean L" uniqKey="Rouleau J" first="Jean L." last="Rouleau">Jean L. Rouleau</name>
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<country name="États-Unis"><region name="Wisconsin"><name sortKey="Roecker, Ellen B" sort="Roecker, Ellen B" uniqKey="Roecker E" first="Ellen B." last="Roecker">Ellen B. Roecker</name>
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<name sortKey="Cohn, Jay N" sort="Cohn, Jay N" uniqKey="Cohn J" first="Jay N." last="Cohn">Jay N. Cohn</name>
<name sortKey="Fowler, Michael B" sort="Fowler, Michael B" uniqKey="Fowler M" first="Michael B." last="Fowler">Michael B. Fowler</name>
<name sortKey="Holcslaw, Terly L" sort="Holcslaw, Terly L" uniqKey="Holcslaw T" first="Terly L." last="Holcslaw">Terly L. Holcslaw</name>
<name sortKey="Packer, Milton" sort="Packer, Milton" uniqKey="Packer M" first="Milton" last="Packer">Milton Packer</name>
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<country name="Pologne"><noRegion><name sortKey="Tendera, Michal" sort="Tendera, Michal" uniqKey="Tendera M" first="Michal" last="Tendera">Michal Tendera</name>
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<country name="Suisse"><region name="Canton de Berne"><name sortKey="Mohacsi, Paul" sort="Mohacsi, Paul" uniqKey="Mohacsi P" first="Paul" last="Mohacsi">Paul Mohacsi</name>
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<name sortKey="Scherhag, Armin" sort="Scherhag, Armin" uniqKey="Scherhag A" first="Armin" last="Scherhag">Armin Scherhag</name>
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<country name="Australie"><noRegion><name sortKey="Krum, Henry" sort="Krum, Henry" uniqKey="Krum H" first="Henry" last="Krum">Henry Krum</name>
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<name sortKey="Coats, Andrew J S" sort="Coats, Andrew J S" uniqKey="Coats A" first="Andrew J. S." last="Coats">Andrew J. S. Coats</name>
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<country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Katus, Hugo A" sort="Katus, Hugo A" uniqKey="Katus H" first="Hugo A." last="Katus">Hugo A. Katus</name>
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<country name="France"><region name="Île-de-France"><name sortKey="Castaigne, Alain" sort="Castaigne, Alain" uniqKey="Castaigne A" first="Alain" last="Castaigne">Alain Castaigne</name>
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{{Explor lien
   |wiki=    Wicri/Asie
   |area=    AustralieFrV1
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   |type=    RBID
   |clé=     Pascal:04-0355490
   |texte=   Influence of pretreatment systolic blood pressure on the effect of Carvedilol in patients with severe chronic heart failure: The Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) study. Author's reply
}}

This area was generated with Dilib version V0.6.33.
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	Serveur d'exploration sur les relations entre la France et l'Australie
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Serveur d'exploration sur les relations entre la France et l'Australie

Influence of pretreatment systolic blood pressure on the effect of Carvedilol in patients with severe chronic heart failure: The Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) study. Author's reply

Influence of pretreatment systolic blood pressure on the effect of Carvedilol in patients with severe chronic heart failure: The Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) study. Author's reply

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