Celiprolol in the treatment of exercise induced angina pectoris

A multicenter, double-blind placebo controlled study was designed to examine the efficacy of celiprolol in exercise induced angina pectoris. The study consisted of a 4-week placebo run-in period, 6-week titration, 4-week maintenance, 2-week tapering and a 2-week placebo run-out period. Entry criteria were a history of stable angina with chest pain and 1 mm ST segment depression between 3 and 12 min after start of treadmill exercise stress test. Patients started with celiprolol 200 mg daily for 2 weeks; non-responders received 400 mg daily for 2 weeks and then if necessary 600 mg daily for another 2 weeks. A 20% increase over baseline in exercise stress test to onset of angina was considered a response. Ninety-two patients were evaluated, 54 in the celiprolol group and 38 in the placebo group; 63 men and 29 women, mean age 57 years. The celiprolol group was significantly different from placebo after 6 weeks. In particular, exercise time increased by 4.3 min (placebo increased by 0.3 min), ST segment depression reduced by 0.4 mm, notwithstanding the increase in exercise time (placebo increased by 0.2 mm), maximum exercise heart rate reduced by 6 beats per min (placebo increased by 3 beats per min), maximum exercise systolic BP reduced by 14 mm Hg (placebo decreased by 1 mm Hg). The therapeutic success rate based on a 20% increase of exercise time was 85% after celiprolol and zero after placebo. Reduction in weekly angina attacks and nitroglycerin consumption was from 8 to 3 after celiprolol and from 9 to 6 after placebo.(ABSTRACT TRUNCATED AT 250 WORDS)