There are few data regarding anti-anginal effects between beta-blockers with and without vasodilating property. Beta-blocker without vasodilating property is generally known to have unfavorable effects on glucose and lipid metabolism. Therefore, the investigators compared carvedilol and atenolol on anti-anginal and metabolic effects in patient with stable angina pectoris.
Previous studies have demonstrated that beta-blockers are effective in reducing not only ischemia but also cardiovascular mortality following myocardial infarction. And, recent guidelines have suggested the potential for use of beta-blockers as first-line agents in chronic stable angina. However, beta-blockers are a diverse class with different mechanisms of action and physiological effects. Various pharmacologic properties that characterize beta-blockers include cardioselectivity, intrinsic sympathomimetic activity, and concomitant vasodilating alpha-adrenoceptor blockade, which might exhibit differential anti-anginal efficacies. In addition, traditional beta-blockers, particularly nonvasodilating beta-blockers, have been reported to have negative metabolic effects, including hyperglycemia, insulin resistance, and dyslipidemia. These unfavorable effects of beta-blockers should be considered in patients with stable angina pectoris, because the pathophysiology of coronary artery disease is associated with abnormalities in glucose and lipid metabolism. Carvedilol, a newer vasodilating beta-blocker, has been shown to differ from traditional beta-blockers in terms of metabolic effects in patients with hypertension and diabetes. However, few data regarding comparative anti-anginal and metabolic effects between beta-blockers with and without vasodilating property have been reported, particularly in patients with angina pectoris. In this study, we simultaneously compared anti-anginal and metabolic effects of carvedilol and atenolol in patients with stable angina pectoris.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
99
Gachon University Gil Medical Center
Incheon, South Korea
Time to 1-mm ST-segment depression
Time to 1-mm ST-segment depression at exercise treadmill test
Time frame: After 25 weeks of treatment
Time to onset of angina
Time to onset of angina at exercise treadmill test
Time frame: After 25 weeks of treatment
Blood pressure at resting and peak exercise
Blood pressure at resting and peak exercise during exercise treadmill test
Time frame: After 25 weeks of treatment
Heart rate at resting and peak exercise
Heart rate at resting and peak exercise during exercise treadmill test
Time frame: After 25 weeks of treatment
Lipid profiles
Lipid profiles: total cholesterol, triglyceride, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol
Time frame: After 25 weeks of treatment
Glucose metabolism
Fasting glucose, insulin, HbA1c, Quantitative Insulin-Sensitivity Check Index (QUICKI)
Time frame: After 25 weeks of treatment
Seattle Angina Questionnaire (SAQ) scores
Time frame: After 25 weeks of treatment
Treatment-emergent adverse events
Time frame: After 25 weeks of treatment
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