DARMSTADT, Germany, Nov. 1 /PRNewswire/ -- The following was issued today
by Merck KGaA:
A major international heart failure symposium held in Lisbon provided a
unique opportunity for experts in drug therapy and implantable devices to
share their knowledge in the fight against one of the most pressing public
health problems in the world today.
"A new look at the heart in heart failure," the VIIIth Pan-European
Scientific Symposium, was held in Lisbon, Portugal on 26-27 October 2001.
Over 300 heart failure specialists gathered to discuss important new advances
in the treatment of heart failure (HF) -- already one of the Western world's
biggest killers, and becoming increasingly more common.
The symposium was co-chaired by three well-known experts in HF: Gunter
Breithardt (Munster, Germany), Faiez Zannad (Nancy, France), and Pedro Adragao
(Lisbon, Portugal). The 22 presentations by an internationally-renowned
faculty focused on the pathophysiology of HF, its burden on patients and
society, and, most crucially, its management -- how to make patients feel
better and live longer.
This fascinating opportunity to combine expertise in two complementary
areas of cardiology, drugs and technology, was sponsored by Merck KGaA,
developers of the beta-blocker Concor/Concor Cor (bisoprolol), and Guidant,
pioneers and developers of cardiac resynchronization therapy (CRT) systems
such as CONTAK TR, RENEWAL and the EASYTRAK coronary sinus lead. Both
companies have a long track record of innovation in cardiovascular medicine,
and a commitment to serving the unmet needs of the millions of people
suffering from HF worldwide.
Heart Failure
HF is a widespread, growing condition that robs people of quality and
quantity of life. Nearly 6.5 million people in Europe, 5 million people in
the US, and 2.4 million people in Japan currently suffer from HF. Nearly
one million new cases of HF are diagnosed annually worldwide, making it the
most rapidly growing cardiovascular disorder. Three-quarters of all patients
hospitalized for the first time with HF will die within five years; a survival
rate far worse than cancer. HF is also a very hard disease to live with,
diminishing patients' ability to perform normal levels of activity and
impairing quality of life more than almost any other chronic medical problem.
"Heart failure combines a high prevalence with a terrible burden of
symptoms and morbidity, all of these contributing to a huge societal cost,"
said John McMurray (Glasgow, UK). It affects 1-3% of the general population,
and about 10% of the very elderly. Unlike most cardiovascular diseases, HF is
becoming more common, and now accounts for about 5% of all medical admissions
in Europe and about 2% of all hospital expenditure.
Beta-Blockers reduce death by a third
In recent years, however, medical research has offered new hope to
patients with HF. Much more is now known about the neurohormonal mechanisms
underlying the development and progression of the disease. "Pharmacotherapy
based on these concepts has significantly improved prognosis," said
Breithardt. In the past, treatment was based on diuretics and digoxin, which
relieve symptoms but do not reduce mortality. These treatments are still
used, but have now been joined by the ACE inhibitors and beta-blockers --
agents conclusively shown to save lives.
The introduction of beta-blockers as a standard treatment for HF
represents a revolution in medicine, as they were once thought to be
contra-indicated in this condition. However, in the last three years,
three major mortality trials -- CIBIS II, MERIT-HF, and COPERNICUS -- have
established that bisoprolol, metoprolol and carvedilol cut HF deaths by a
third when added to standard therapy with ACE inhibitors and diuretics.
The latest European guidelines therefore state that beta-blockers are
indicated for the treatment of all patients with stable, mild, moderate and
severe HF. Yet, across Europe, fewer than 40% of patients receive this
potentially life-saving treatment. "Research is needed to hasten the
implementation of trial results into clinical practice," said Zannad.
"Education and implementation programmes should be designed to fight
ignorance, incredulity and inaction, the three main reasons for doctors'
non-compliance with guidelines."
Cardiac resynchronization: a major new therapeutic option
Meanwhile, a major new therapeutic option available in Europe has emerged
that can potentially improve quality of life for selected patients -- cardiac
resynchronization therapy (CRT). In 20-40% of HF patients, electrical
conduction delays in the ventricles (the lower chambers of the heart) cause
the contraction of the heart chambers to become dyssynchronized, making the
heart even less efficient in pumping blood.
Implantable CRT devices market approved in Europe, such as CONTAK TR or
RENEWAL developed by Guidant, are designed to stimulate both ventricles of the
heart electrically, restoring their synchrony, and allowing them to pump blood
more efficiently. CRT pioneer Angelo Auricchio (Magdeburg, Germany) explained
that three randomized controlled trials (PATH-HF, MUSTIC and MIRACLE) have
already shown that CRT improves HF functional status (NYHA class), and
increases exercise capacity and quality of life. Two major ongoing trials,
COMPANION and CARE-HF, are currently investigating whether CRT reduces
mortality and morbidity.
Sudden cardiac death (SCD) accounts for nearly half the deaths in people
with HF. Often, SCD occurs due to extremely fast ventricular arrhythmias. To
prevent SCD from arrhythmias, RENEWAL incorporates Guidant's proven
defibrillator therapy.
"There is now sufficient evidence that CRT is beginning to show beneficial
effects on left ventricular performance that translate into benefits for
patients," commented Breithardt. Many HF patients may benefit from CRT.
Thus, though much remains to be done, significant progress is being made in
both drugs and devices for HF -- one of the most important threats to health
in the industrialized countries today.
Breithardt concluded, "The effects of beta-blockers and CRT may even prove
synergistic, as the pacing provided by CRT may permit more HF patients to
receive beta-blockers."
Note:
The book of abstracts and more detailed information about heart failure
and its treatment can be found on the internet: Please check the November 1
press release on the media/investor relations section of the Merck website
( http://www.merck.de )
Guidant Corporation pioneers lifesaving technology, giving an opportunity
for better life today to 7 million cardiac and vascular patients worldwide.
The company, driven by a strong entrepreneurial culture of 10,000 employees,
develops, manufactures and markets a broad array or products and services that
enable less invasive care for some of life's most threatening medical
conditions.
Headquartered in Darmstadt/Germany, the Merck Group generated sales of
EUR 6,7 billion in 2000 in the fields of Pharmaceuticals, Specialty Chemicals,
Lab Products and Lab Distribution. Founded in 1668, the Merck Group is
represented today by more than 200 companies in 52 countries and employs
34,300 people worldwide. The company groups its operating activities under
Merck KGaA, in which E. Merck, as a general partner, holds the Merck family's
74 percent equity interest in Merck KGaA. The Merck Group strongly believes
that promotion of its employees' self-initiative and self-responsibility,
application-oriented research and development and close customer relationships
in the markets are the keys to long-term corporate success.
SOURCE Merck KGaA
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Related links:
http://www.merck.de
CONTACT:
Dr. Hartmut Vennen, +49-61-51-72-23-86, or
Patricia Verkenne, Clinical R&D - Clinical Sciences,
+49-6151-72-7187, or patricia.verkenne@merck.de, both of Merck
KGaA; or Jan Pieter Heemels, Corporate Marketing of Guidant
Europe, +32-2-714-1426, or jheemels@guidant.com
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