B-type natriuretic peptides (BNP and PRO-BNP) predict longterm survival in patients with advanced heart failure treated with atenolol.

(TX). Methods: The study was designed as a double-blind, randomized, placebo-controlled trial and conducted in 3 German transplant centers. Study duration was 12 months. Patients accepted for TX with advanced left ventricular (LV) systolic dysfunction categorized as NYHA IV at least once since onset of CHF were eligible. The primary endpoint was the absolute change from baseline to latest available LV ejection fraction (EF) measurement determined by radionuclide ventriculography between Carvedilol and placebo. Results: The trial prospectively randomized 118 patients with CHF of ischemic (n544) or non-ischemic (n574) etiology, a mean 6SD [median] age of 53.369.8 [55.5] years, and a mean LVEF at baseline of 19.966.6 [20.1]%. Mean 6SD [median] absolute change of LVEF from baseline was 16.069.3 [13.9]% in the Carvedilol group versus 10.767.1 [0.0]% in the placebo treated patients (p,0.008 [,0.006, Wilcoxon, 2-sided]) in the intention-to-treat population (n574) and 18.2610.3 [16.0]% in Carvedilol versus 11.467.9 [0.0]% on placebo (p,0.011 [,0.013, Wilcoxon, 2-sided]) in the per-protocol population (n552). Serious adverse events were experienced by 33/60 patients (13 deaths) on placebo and 29/58 patients (9 deaths) on Carvedilol. Conclusion: Even in patients with endstage CHF accepted for TX pharmacological therapy may significantly improve cardiac function over a prolonged period of time. Carvedilol appears to be an appropriate and safe drug also in this severely ill patient population. Thus, the EFICAT trial extends the observations made in COPERNICUS.