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  • Title: [Antiischemic and metabolic effects of nebivolol and metaprolol CR/XL (betalok ZOK) in patients with postinfarction heart dysfunction].
    Author: Tepliakov AT, Kuznetsova AV, Stepacheva TA, D'iakova ML, Shilov SN, Bolotskaia LA.
    Journal: Klin Med (Mosk); 2005; 83(4):56-9. PubMed ID: 15941146.
    Abstract:
    The purpose of the study was to evaluate anti-ischemic and metabolic effects of the cardioselective beta-adrenoblockers nebivolol and retarded metoprolol-metaprolol CR/XL (betalok ZOK) in patients with postinfarction heart dysfunction, associated with type II diabetes mellitus (DM). 40 patients with coronary heart disease (CHD), functional class (FC) II-III exertional angina, postinfarction left ventricular (LV) dysfunction, and NYHA FC II heart failure, associated with type II DM, were randomized into 2 groups. The 20 patients of the 1st group were administered nebivolol in a dose of 1.25 to 5 mg per day, the 20 patients of the 2nd group - betalok ZOK in a dose of 12.5 to 100 mg per day. The course therapy lasted 8 weeks. The effects of the treatment were evaluated using paired veloergometry, echoCG, and lipid spectrum analysis. The study found that nebivolol in a mean dose of 4.2 +/- 0.3 mg per day and betalok ZOK in a dose of 46.5 +/- 6.2 mg per day reduced the frequency and severety of angina attacks (by 73.8% and 67.8%, respectively) and daily nitroglycerine uptake (by 78.6% and 69.1%, respectively), and increased activity tolerance (by 7.9% and 25.3%, respectively). None of the preparations displayed any adverse effects on carbohydrate exchange and blood lipid spectrum. Nebivolol, unlike betalok ZOK, significantly (p = 0.02) reduced triglyceride blood level by 29%. Thus, the new generation cardioselective beta1-adrenoblockers nebivolol and metoprolol CR/XL (betalok ZOK) provide anti-ischemic and metabolic effects in patients with CHD and postinfarction LV dysfunction, associated with type 2 diabetes mellitus. Nebivolol is preferable as far as blood lipid spectrum is concerned.
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