Evidence map›Paper›PMID 28244261›Full record

Trial reportJournal of cachexia, sarcopenia and muscle2017

Effect of beta-adrenergic blockade with carvedilol on cachexia in severe chronic heart failure: results from the COPERNICUS trial.

Andrew L Clark, Andrew J S Coats, Henry Krum, Hugo A Katus, Paul Mohacsi, Damien Salekin, Melissa K Schultz, Milton Packer, Stefan D Anker

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of cachexia, sarcopenia and muscle, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 2 pooled it
18.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 2 syntheses or guidelines pooled it, 94 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  12. Coincidence of sarcopenia and body weight loss.Geriatrics & gerontology international · 2024
    Article
  13. Review
  14. Review
  15. Review
  16. Article
  17. Article
  18. Locomotor and respiratory muscle abnormalities in HFrEF and HFpEF.Frontiers in cardiovascular medicine · 2023
    Review
  19. Treating sarcopenia: the LACE trial.Journal of cachexia, sarcopenia and muscle · 2022
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 5 countries.

Andrew L ClarkDepartment of Cardiology, University of Hull, UK.
Andrew J S CoatsMonash University, Melbourne, VIC, Australia.
Henry KrumDepartments of Epidemiology and Preventive Medicine and Medicine, Monash University, Melbourne, Australia.
Hugo A KatusKlinik für Kardiologie, Angiologie und Pneumologie, Medizinische Universitätsklinik, Heidelberg, Germany.
Paul MohacsiDepartment of Cardiology, University Hospital, Bern, Switzerland.
Damien SalekinDepartment of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA.
Melissa K SchultzDepartment of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA.
Milton PackerCenter for Biostatistics and Clinical Science, University of Texas Southwestern Medical School, Dallas, TX, USA.
Stefan D AnkerInnovative Clinical Trials, University Medicine Göttingen, Germany.
University of Wisconsin–Madison · USChirurgische Universitätsklinik Heidelberg · DEMonash University · AUThe University of Texas Southwestern Medical Center · USUniversity Hospital of Bern · CHUniversity of Hull · GBUniversity of Warwick · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac cachexia frequently accompanies the progression of heart failure despite the use of effective therapies for left ventricular dysfunction. Activation of the sympathetic nervous system has been implicated in the pathogenesis of weight loss, but the effects of sympathetic antagonism on cachexia are not well defined.

methodsWe prospectively evaluated changes in body weight in 2289 patients with heart failure who had dyspnoea at rest or on minimal exertion and a left ventricular ejection fraction <25%. Patients were randomly assigned (double-blind) to receive either placebo (n = 1133) or carvedilol (n = 1156) and were followed for the occurrence of major clinical events for up to 29 months (COPERNICUS trial). Patients were not enrolled if they had signs of clinically significant fluid retention due to heart failure.

resultsPatients in the carvedilol group were 33% less likely than patients in the placebo group to experience a further significant loss of weight (>6%) (95% confidence interval: 14-48%, P = 0.002) and were 37% more likely to experience a significant gain in weight (≥5%) (95% confidence interval: 12-66%, P = 0.002). Carvedilol's ability to prevent weight loss was most marked in patients with increased body mass index at baseline, whereas its ability to promote weight gain was most marked in patients with decreased body mass index at baseline. Increases in weight were not accompanied by evidence of fluid retention. Baseline values for body mass index and change in body weight were significant predictors of survival regardless of treatment.

conclusionsCarvedilol attenuated the development and promoted a partial reversal of cachexia in patients with severe chronic heart failure, supporting a role for prolonged sympathetic activation in the genesis of weight loss.

Indexed as

Adrenergic beta-AntagonistsAgedAged, 80 and overBody WeightCachexiaCarbazolesCarvedilolChronic DiseaseDouble-Blind MethodFemaleHeart FailureHumansMaleMiddle AgedPlacebosPropanolaminesAdrenergic beta-AntagonistsCarbazolesCarvedilolPlacebosPropanolaminesCardiac cachexiaCarvedilolCOPERNICUS trialHeart failureSympathetic nervous systemWeight loss

Identifiers

PMID28244261
PMCPMC5566644
OpenAlexW2593098842

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.