Jun 5, 2003
Guidant and Merck KGaA Continue Collaboration on Heart Failure Education

International Symposium Offers Unique Opportunity for Experts in Device and Drug Therapies to Share Knowledge

Indianapolis, IN - A major international heart failure symposium co-sponsored by Guidant Corporation (NYSE: GDT) and Merck KGaA of Germany provided a unique opportunity for over 300 experts in device-based and drug therapy to share their knowledge in the treatment of one of the most pressing public health problems in the world today - heart failure.

Guidant and Merck KGaA''s co-sponsorship of this symposium represents a collaborative effort to bring advancements in optimal therapy that includes device-based and drug therapies to physicians. By leveraging their broad scientific and medical expertise, Guidant and Merck KGaA are increasing awareness of new treatment options for heart failure. The symposium provided a unique opportunity for heart failure specialists, cardiologists and electrophysiologists, to share information and experiences related to the treatment of heart failure.

According to heart failure expert Erland Erdmann (Köln, Germany), a symposium co-chairman, "Though much remains to be done, significant progress is being made in both drugs and devices for heart failure - one of the most important threats to health in the industrialized countries today." Erdmann added, "The effects of beta-blockers and Cardiac Resynchronization Therapy (CRT) may even prove synergistic, as the pacing provided by CRT may permit more patients to receive beta-blockers."

The 9th pan-European Scientific Symposium, which was held in Paris, France, from May 30 until June 1, featured 20 presentations by an internationally renowned faculty. Presentations and discussions focused on the physiology of heart failure, its burden on patients and society, and, most crucially, how to help patients live better and live longer by marrying pharmacological therapies with device therapies.

This was the second symposium on heart failure that Guidant and Merck KGaA have organized together. "The first collaborative symposium on heart failure was a great success and the attendees felt it should be repeated," said Nicky Spaulding, president, Europe, Middle East, Africa and Canada, Guidant Corporation.

"Both companies have a long track record of innovation in cardiovascular medicine. Working together we will continue our efforts to serve the unmet needs of people struggling with heart failure," stated Luc Duval, global head of Merck''s cardiovascular franchise.

Guidant Corporation pioneers lifesaving technology, giving an opportunity for better life today to millions of cardiac and vascular patients worldwide. The company, driven by a strong entrepreneurial culture of 11,000 employees, develops, manufactures and markets a broad array of products and services that enable less invasive care for some of life's most threatening medical conditions. For more information visit www.guidant.com.

With more than 34,500 employees in 53 countries, the Merck Group generated sales of EUR 7.5 billion in 2002. Founded in 1668 in Darmstadt, Germany, the company aims to be a world leader within its core businesses of pharmaceuticals and chemicals. The Merck Group strongly believes the key to its long-term business success is innovative products created by entrepreneurial and talented employees. Merck groups its operating activities under Merck KGaA, in which the Merck family holds 74 percent and the remaining 26 percent is publicly traded. The former U.S. subsidiary, Merck & Co., has been a completely independent company since 1917. For more information visit, www.merck.de or www.bisoprolol.com
About Heart Failure

Nearly one million new cases of heart failure are diagnosed annually worldwide, making it the most rapidly growing cardiovascular disorder. An estimated five million people in the U.S., 6.5 million people in Europe, and 2.4 million people in Japan currently suffer from heart failure. Three-quarters of all patients hospitalized for the first time with heart failure will die within five years; a survival rate far worse than cancer. Heart failure is a debilitating condition that affects not only a patient''s quality of life, but also life expectancy. It is a disease in which the heart weakens and gradually loses the ability to pump blood effectively.
About Cardiac Resynchronization Therapy

In many patients with moderate to severe heart failure the heart chambers'' pumping action may be desynchronized, making the heart even less efficient in pumping blood. Implantable cardiac resynchronization therapy (CRT) devices pioneered by Guidant, such as the CONTAK RENEWAL(tm) CRT-defibrillator (CRT-D) systems, are designed to stimulate both ventricles of the heart electrically, to restore synchrony, and, in the case of the CONTAK RENEWAL family, provide defibrillation therapy.
About the COMPANION Trial

Preliminary results of the Guidant-sponsored Comparison of Medical Therapy, Pacing, and Defibrillation in Chronic Heart Failure (COMPANION) trial were presented during the American College of Cardiology meeting in Chicago in March. The COMPANION investigators reported a 19 percent reduction in combined all-cause mortality and all-cause hospitalization for heart failure patients implanted with Guidant''s CRT devices. Furthermore the study showed a 43 percent reduction in all-cause mortality for heart failure patients who received Guidant''s CRT-D device. CRT-P and CRT-D demonstrated a reduction in combined all-cause mortality and heart failure hospitalization of 35 percent and 39 percent, respectively.

"We''ve demonstrated, in a large, randomized, long-term, multi-centered trial, an improvement in those things that we want to change most for heart failure patients, to decrease all-cause mortality and decrease all-cause hospitalization despite a population that had absolutely optimized pharmacologic therapy," said Dr. Bristow, principal investigator of the COMPANION trial and presenter at the symposium. Complete COMPANION trial results are expected to be published in a major peer-reviewed medical journal later this year.
About Pharmacological Treatment

In recent years, however, medical research has offered new hope to heart failure patients. The introduction of beta-blockers as part of standard treatment for chronic heart failure (CHF) represents an advancement in medicine, as they had been contra-indicated for this condition in the past. However, in the last three years, three major mortality trials (one of them being the Cardiac Insufficiency Bisoprolol Study (CIBIS II), performed with Merck's ß1-selective beta-blocker bisoprolol (e.g. Concor® COR, Cardicor®, Cardensiel®) have established that the use of beta-blockers has helped cut heart failure deaths by a third when added to standard therapy with ACE inhibitors and diuretics. European guidelines now state that beta-blockers are mandatory for the treatment of all patients with stable, mild, moderate or severe heart failure.

Beta-blockers have been established for many years as first line therapy for hypertension and coronary artery disease. Their more recent recognition as an essential component of CHF treatment is based on these major trials showing a highly significant reduction in total mortality (by 34 percent in CIBIS II). Beta-blockers are particularly effective in reducing sudden death (by 44 percent in CIBIS II)
About CIBIS III

Today, therefore, it is time to challenge the usual starting sequence for CHF therapy (i.e. ACE inhibitor first, the beta-blocker on top). This is precisely the purpose of the CIBIS III trial, which aims to answer the question of whether initiation of CHF therapy with a beta-blocker is comparable (non-inferior) to the initiation of therapy with an ACE inhibitor. First results of CIBIS III are expected by the end of 2004.