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[Calcium antagonists and primary prevention of coronary disease]
1Karolinska Institutet, Danderyds Sjulhus, Suède.
Insights
Verapamil and metoprolol showed similar effectiveness for stable angina patients over 3.5 years. Both drugs equally impacted mortality, cardiovascular events, and quality of life, with verapamil potentially offering anti-platelet benefits.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Stable angina affects numerous patients worldwide.
- Long-term therapeutic strategies are crucial for managing stable angina prognosis.
- Comparing calcium channel blockers and beta-blockers is essential for treatment optimization.
Purpose of the Study:
- To compare the long-term effects of verapamil and metoprolol on prognosis in patients with stable angina.
- To evaluate the impact of these treatments on mortality, cardiovascular events, and quality of life.
Main Methods:
- The Angina Prognosis Study in Stockholm (APSIS) enrolled 809 patients with stable angina.
- Patients received either verapamil (480 mg/day) or metoprolol (200 mg/day).
- Outcomes were monitored over an average follow-up of 3.5 years.
Main Results:
- No significant differences were observed between verapamil and metoprolol groups regarding mortality.
- Cardiovascular event rates and quality of life scores were comparable between the two treatment arms.
- Verapamil demonstrated similar efficacy and tolerability to metoprolol for long-term stable angina management.
Conclusions:
- Verapamil is a viable and well-tolerated alternative to metoprolol for the long-term therapy of stable angina.
- An ancillary study suggested a potential platelet anti-aggregant effect of verapamil.
- These findings support individualized treatment choices in stable angina management.
Abstract:
APSIS (Angina Prognosis Study in Stockholm) compared the effects of verapamil 480 mg/day and metoprolol 200 mg/day on the prognosis of 809 patients with stable angina over an average period of three and a half years. No difference was observed between the two treatment groups in terms of mortality, number of cardiovascular events or in term of quality of life. Verapamil seemed to be as effective and as well tolerated as the betablocker for long term therapy of stable angina. Moreover, an ancillary study suggests that it has a platelet anti-aggregant effect.