{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:36:16Z","timestamp":1787960176456,"version":"build-2784847793"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The safety and efficacy of different types of \u03b2-blocker therapy in patients with non\u2013dialysis-dependent chronic kidney disease (CKD) and systolic heart failure (HF) are not well described. We assessed whether treatment of systolic HF with carvedilol is efficacious and safe in adults with CKD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We performed a post hoc analysis of pooled individual patient data (n=4217) from 2 multinational, double-blinded, placebo-controlled, randomized trials, CAPRICORN (Carvedilol Postinfarct Survival Control in Left Ventricular Dysfunction Study) and COPERNICUS (Carvedilol Prospective Randomized, Cumulative Survival study). Primary outcome was all-cause mortality. Secondary outcomes included cardiovascular mortality, HF mortality, first HF hospitalization, the composite of cardiovascular mortality or first HF hospitalization, and sudden cardiac death. Non\u2013dialysis-dependent CKD was defined by estimated glomerular filtration rate \u226460 mL\/min\/1.73 m\n              <jats:sup>2<\/jats:sup>\n              , using the abbreviated Modification of Diet in Renal Disease equation. CKD was present in 2566 of 4217 (60.8%) of the cohort, 50.4% of whom were randomly assigned to carvedilol therapy. Within the CKD group, treatment with carvedilol decreased the risks of all-cause mortality (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.63 to 0.93;\n              <jats:italic>P<\/jats:italic>\n              =0.007), cardiovascular mortality (HR, 0.76; 95% CI, 0.62 to 0.94;\n              <jats:italic>P<\/jats:italic>\n              =0.011), HF mortality (HR, 0.68; 95% CI, 0.52 to 0.88;\n              <jats:italic>P<\/jats:italic>\n              =0.003), first hospitalization for HF (HR, 0.74; 95% CI, 0.61 to 0.88;\n              <jats:italic>P<\/jats:italic>\n              =0.0009), and the composite of cardiovascular mortality or HF hospitalization (HR, 0.75; 95% CI, 0.65 to 0.87;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) but was without significant effect on sudden cardiac death (HR, 0.76; 95% CI, 0.56 to 1.05;\n              <jats:italic>P<\/jats:italic>\n              =0.098). There was no significant interaction between treatment arm and study type. Carvedilol was generally well tolerated by both groups of patients, with an increased relative incidence in transient increase in serum creatinine without need for dialysis and other electrolyte changes in the CKD patients. However, in a sensitivity analysis among HF subjects with estimated glomerular filtration rate &lt;45 mL\/min\/1.73 m\n              <jats:sup>2<\/jats:sup>\n              (CKD stage 3b), the efficacy of carvedilol was not significantly different from placebo.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>This analysis suggests that the benefits of carvedilol therapy in patients with systolic left ventricular dysfunction with or without symptoms of HF are consistent even in the presence of mild to moderate CKD. Whether carvedilol therapy is similarly efficacious in HF patients with more advanced kidney disease requires further study.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.109.932558","type":"journal-article","created":{"date-parts":[[2010,10,30]],"date-time":"2010-10-30T00:57:09Z","timestamp":1288400229000},"page":"18-26","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":85,"title":["Efficacy and Safety of Carvedilol in Treatment of Heart Failure with Chronic Kidney Disease"],"prefix":"10.1161","volume":"4","author":[{"given":"Ravinder K.","family":"Wali","sequence":"first","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malini","family":"Iyengar","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald J.","family":"Beck","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Chartyan","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Chonchol","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ann","family":"Lukas","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Cooper","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Himmelfarb","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Weir","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Berl","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L.","family":"Henrich","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred K.","family":"Cheung","sequence":"additional","affiliation":[{"name":"From the University of Maryland School of Medicine (R.K.W., M.R.W.), Baltimore, Md; GlaxoSmithKline (M.I., M.A.L.), King of Prussia, Pa; the Cleveland Clinic Foundation (G.J.B.), Department of Quantitative Health Sciences, Cleveland, Ohio; Brigham and Women's Hospital (D.M.C.), Harvard Medical School, Boston, Mass; the University of Colorado Health Science Center (M.C., T.B.), Renal Diseases and Hypertension, Denver, Colo; the University of Toledo (C.C.), Toledo, Ohio; the University of Washington..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020265"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe020115"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.2.194"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-2-200307150-00013"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00608-7"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.2.203"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.580506"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(99)70009-8"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006101159"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006121347"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.23.2630"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.17.2038"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.3.344"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.07.031"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2003.08.012"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(99)70113-4"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.07.067"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000116764.53225.A9"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.561423"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02125-3"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-11-200306030-00013"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2001.22070"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.11.1377"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.5.685"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.10.005"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.15.1900"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.06.072"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1586\/14779072.5.1.21"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199812103392407"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04560-8"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.6.712"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-199219001-00019"},{"key":"e_1_3_2_34_2","first-page":"378","article-title":"Carvedilol improves renal hemodynamics in patients with chronic heart failure [abstract]","volume":"98","author":"Abraham WT","year":"1998","unstructured":"Abraham WT, Tsvetkova T, Lowes BD. 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