Related Experiment Videos
[Celiprolol in the treatment of chronic stable angina]
O Román1, G Cuevas, D Martínez
1Departamento de Cardiología, Hospital Clínico San Borja-Arriarán, Santiago de Chile.
Insights
Celiprolol effectively reduced angina episodes and improved exercise tolerance in patients with coronary artery disease. This beta-blocker demonstrated significant benefits for stable angina, enhancing quality of life.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary artery disease (CAD) and stable angina remain significant health concerns.
- Beta-blockers are a cornerstone in managing angina, but novel agents are sought.
- Celiprolol, a third-generation beta-blocker, possesses intrinsic vasodilator properties.
Purpose of the Study:
- To evaluate the efficacy of celiprolol in patients with chronic stable angina.
- To assess the impact of celiprolol on angina frequency, exercise tolerance, and ischemic thresholds.
Main Methods:
- A randomized, placebo-controlled study involving 20 patients with CAD and stable angina.
- Patients received a fixed dose of 400 mg celiprolol daily for 3 months after a 1-month placebo phase.
- Exercise stress tests were conducted to measure angina and ischemic thresholds, and work capacity.
Main Results:
- Celiprolol significantly reduced weekly angina episodes (2.4 vs. 7.2, p < 0.001).
- Patients experienced higher angina thresholds (667 vs. 337 sec, p < 0.025) and ischemia thresholds (614 vs. 401 sec, p < 0.001).
- Work capacity increased (3937 vs. 2403 kgm/min, p < 0.01), with 9 patients reporting no exercise-induced pain.
Conclusions:
- Celiprolol is effective in decreasing daily angina episodes in patients with chronic stable angina.
- The drug significantly improves exercise tolerance and ischemic parameters.
- Celiprolol is well-tolerated, with mild adverse effects reported in a minority of patients.
Abstract:
Celiprolol is a third generation beta blocking drug with intrinsic vasodilator effect. We evaluated the effect of this drug at a fixed dose of 400 mg daily in 20 patients with coronary artery disease and stable angina having 2 to 40 episodes of pain a week. All patients had positive exercise stress test with greater than 1 mm ST depression. Compared to the 1 month baseline placebo phase, patients after 3 months of treatment with celiprolol had less episodes of angina (2.4 vs 7.2 a week, p less than 0.001), higher angina threshold (667 vs 337 sec, p less than 0.025), higher ischemia threshold (614 vs 401 sec, p less than 0.001) and were able to perform more work (3937 vs 2403 kgm/min. p less than 0.01). 9 patients had no pain during exercise. A decrease in blood pressure, heart rate and double product was evident in the stress tests of the active phase. Adverse effects included headache (4 patients), sweating (1) and fatigue (1) not requiring modification of drug dose. No adverse effects were seen in 13 patients. Thus, celiprolol is effective to decrease angina during daily life and increase exercise tolerance in patients with chronic stable angina pectoris.