CAPRICORN study provides evidence of beta blocker benefits post-MI

The results of the CAPRICORN (Carvedilol Post Infarction SurvivalControl in Left Ventricular Dysfunction) study, evaluating the effect of GlaxoSmithKline and Roche's carvedilol in the treatment of patients in the early phase of heart failure after a myocardial infarction, demonstrate that long-term treatment with the beta blocker can reduce the risk of patients having another MI by 41% and dying by 23%. The results were presented at the American College of Cardiology meeting in Orlando, Florida, on March 20.

The benefits of beta blockers on long-term outcome following acute MI had been demonstrated prior to the introduction of thrombolysis and ACE inhibitors and before the widespread use of aspirin, but CAPRICORN is the first major trial designed specifically to address the role of this drug class in AMI patients on top of the widespread routine use of ACE inhibitors, thrombolytics and aspirin. Most of the previous studies involving post-MI patients with other beta blockers were conducted during the 1970s and 1980s, a time when patients did not routinely receive such background therapy.

The earlier COPERNICUS study of carvedilol, an update of which was also presented at the ACC meeting, already supports the use of the drug in patients with established (New York Heart Association Class II and III) heart failure, and showed that the beta blocker reduced all-case mortality by 35% compared to placebo (Marketletter November 20, 2000). However, the CAPRICORN study is notable in that it included patients with significant left ventricular dysfunction after their MI, a group that has never before been specifically studied in post-MI trials of beta blockers.