COPERNICUS

Carvedilol Prospective Randomized Cumulative Survival Study

Patient / Population Intervention / Exposure Comparison Outcome

In 2,289 patients with severe heart failure and EF ≤ 25%, carvedilol reduced all-cause mortality compared with placebo.

2,289

Design

Double-blind placebo-controlled RCT, stopped early for benefit

Endpoint

All-cause mortality

Relevance

Result130/1156 deaths (11.2%) with carvedilol vs 190/1133 (16.8%) with placebo — a 35% relative risk reduction (95% CI 19-48; P=0.00013).

Packer M, et al. N Engl J Med. 2001;344(22):1651-1658. 10.1056/NEJM200105313442201

Discussion & critique

Excluded truly decompensated/volume-overloaded patients, so applies to euvolaemic severe HF. Showed beta-blockade is safe and life-saving even in severe (NYHA III-IV) HFrEF, extending beta-blocker use across the severity spectrum.