Milton Packer

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Milton Packer (born about 1951) is an American cardiologist known for his research on heart failure. He was born in the United States to Holocaust survivors and grew up in Philadelphia. He studied at Pennsylvania State University (BA, 1971) and Jefferson Medical College in Philadelphia (MD, 1973) at age 22. He trained in New York, doing residency at Albert Einstein College of Medicine and a cardiology fellowship at Mount Sinai School of Medicine, where he worked with Edmund Sonnenblick and Richard Gorlin.

Packer rose through the ranks at Mount Sinai, becoming a full professor in 1988. In 1992 he moved to Columbia University to lead a heart failure research program. In 2004 he moved to the University of Texas Southwestern Medical Center as a trailing spouse and helped create a center to teach clinical research and support doctors’ careers. The center brought statisticians together with physicians to improve trial design, and he received an NIH Clinical and Translational Science Award in 2007. In 2015 he became a distinguished scholar at Baylor University Medical Center at Dallas.

In his research career, Packer helped popularize the neurohormonal theory of heart failure, publishing a key paper on the idea in 1992. He joined the FDA in 1986 on the Cardiorenal Drugs Advisory Committee, an experience he called life-changing and crucial for public health.

He led many large multi-center trials of heart failure drugs, including REFLECT, PROFILE, PRAISE, PRAISE 2, PROMISE, ATLAS, PRECISE, COPERNICUS, ENABLE, REACH-1, OVERTURE, REVIVE I and II, and TRUE-AHF. He chaired studies such as RADIANCE (digoxin with ACE inhibitors) and RENEWAL (etanercept). He was co-principal investigator of the PARADIGM-HF trial, which led to the approval of the drug combination valsartan/sacubitril.

Some trials ended early after negative results, including PROFILE and REACH-1; their full publications weren’t available until years later, a situation clarified in 2017. The success of PARADIGM-HF validated the neurohormonal hypothesis, while an earlier drug, omapatrilat, failed due to safety issues. Packer helped found and lead the Heart Failure Society of America and received the Lewis Katz Lifetime Achievement Award in Cardiovascular Research.