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Celiprolol vs propranolol in unstable angina pectoris: a double-blind, randomized, parallel-group study
T J Cleophas1, M van 't Leven, F H Kauw
1Department of Internal Medicine, Merwede Hospital Sliedrecht-Dordrecht, Leyden, The Netherlands.
Angiology
|February 1, 1995
Summary
Celiprolol, a beta blocker with vasodilator properties, was more effective than propranolol in reducing angina frequency in patients with coronary artery disease. Its benefits are linked to improved peripheral blood flow.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Unstable angina pectoris (UAP) poses a significant clinical challenge.
- Beta-blockers are a cornerstone in managing UAP.
- Novel beta-blockers with additional properties warrant investigation.
Purpose of the Study:
- To compare the efficacy of celiprolol, a selective beta-1 blocker with vasodilator properties, against propranolol, a non-selective beta-blocker, in patients with UAP.
- To investigate the role of receptor selectivity and vasodilator effects in beta-blocker efficacy for UAP.
Main Methods:
- A randomized study involving 53 patients with coronary artery disease and recurrent UAP.
- Patients received either celiprolol (200 mg/day) or propranolol (80 mg/day) for one week.
- Outcomes measured included angina frequency, myocardial oxygen demand (double product), and forearm blood flow.
Main Results:
- Angina frequency was significantly lower in the celiprolol group compared to the propranolol group (P < 0.01).
- Both drugs equally reduced myocardial oxygen demand (double product).
- Forearm blood flow was significantly higher with celiprolol (P < 0.001).
Conclusions:
- Both celiprolol and propranolol effectively reduce angina frequency in UAP.
- Celiprolol demonstrated superior efficacy, providing near-complete relief in three times more patients than propranolol.
- The enhanced efficacy of celiprolol is largely attributed to its vasodilator property, influencing peripheral blood flow.