'Miracle' drug to cut heart failure deaths

A remarkable new drug that outperforms the best treatments available should become the first choice for patients with heart failure, research shows.

Clinical trials were stopped early because of the promise shown by the new medication.

Research on more than 8000 patients found that the experimental drug saved 20% more lives than existing "gold standard" treatments.

Cardiologists in Barcelona for the European Cardiology Society congress, said the new compound, LCZ696, was "a major advance" in the treatment of a "terrible problem".

Heart failure occurs when the heart has been damaged, for example, by a heart attack and can no longer pump blood around the body as well as it once did.

Symptoms can include breathlessness, tiredness and palpitations.

About 68000 new diagnoses are made each year in the UK, with 750000 sufferers overall.

Among people aged 75 to 84, about one in 15 people suffers from the problem, rising to one in seven among those aged 85 and over. Researchers said the new drug, produced by pharmaceutical company Novartis, helps patients with the condition to live longer, stay out of hospital and feel better.

John McMurray, Professor of Cardiology at the University of Glasgow and co-leader of the trial, said: "We have what we believe is a much more effective replacement for one of the gold standard drugs for the treatment of heart failure. This is a major advance in the treatment of this terrible problem."

Patients in the UK who suffer heart failure are recommended to take the drug Enalapril.

The treatment works by inhibiting hormones which are stimulated by damage to the heart muscle, which would otherwise constrict the blood vessels. Researchers say the new compound is more effective, because it not only blocks the "bad" hormones, but also boosts the production of useful ones, which help the failing heart.

The study of 8442 patients with heart failure saw participants given either current conventional treatment, or the new drug. In total, 21.8% of patients given the novel treatment - which has yet to be licensed for use - died from cardiovascular causes, compared with 26.5% of those given Enalapril.

When deaths from all causes were compared, there were 16% more deaths among those given the current standard treatment, compared with those given LCZ696, the study found. Rates of admission to hospital were 21% lower among those who were given the new drug.

The researchers said the results were emphatic enough to bring the trial to an early end, at 27 months. The drug could be licensed for use by next year.

When the heart muscle is damaged, the body responds to the low flow of blood by stimulating production of hormones such as angiotensin II and noradrenaline. These hormones constrict blood vessels and make it harder for the failing heart to pump blood.

The current "gold standard" therapy, Enalapril, works by blocking these hormones.

McMurray said: "What this new drug LCZ696 does is simultaneously inhibit the bad hormones, like Enalapril, but in addition boosts the production of beneficial hormones.

"Several of these beneficial substances stimulate the kidneys to produce more urine to excrete sodium and water and act to relax blood vessels.

"All of these actions unload the failing heart. By having this dual effect, LCZ696 had extra beneficial actions compared with Enalapril, and, in this way, improved patient outcomes."

The cardiologist said the new drug should soon replace the present treatment. "Compared with our gold-standard treatment, LCZ696 made patients live longer, stay out of hospital and feel better, fulfilling all our goals," he said.