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Celiprolol and propranolol for unstable angina pectoris
T J Cleophas1, M van 't Leven, F H Kauw
1Department of Medicine, Merwede Hospital Sliedrecht-Dordrecht, The Netherlands.
Clinical Pharmacology and Therapeutics
|January 1, 1995
Summary
Celiprolol, a beta-blocker with vasodilatory properties, significantly improved angina frequency more than propranolol in unstable angina patients. Its beneficial effects are linked to improved peripheral blood flow.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Unstable angina pectoris (UAP) management remains challenging.
- Celiprolol, a novel beta-blocker, possesses both beta 1-receptor selectivity and vasodilatory properties.
- These properties suggest potential superiority over traditional beta-blockers like propranolol in UAP.
Purpose of the Study:
- To compare the efficacy of celiprolol versus propranolol in patients with unstable angina.
- To investigate the role of beta-receptor selectivity and vasodilatory effects in UAP treatment.
Main Methods:
- A randomized trial involving 53 patients with UAP and coronary artery disease.
- Patients received either celiprolol (200 mg/day) or propranolol (80 mg/day) for one week.
- Outcomes assessed 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).
- Celiprolol significantly increased forearm blood flow (p < 0.001), unlike propranolol.
Conclusions:
- Celiprolol and propranolol both reduce angina frequency in UAP.
- Celiprolol provided superior angina relief, particularly when adjusted for double product reduction.
- The enhanced efficacy of celiprolol is attributed to its vasodilatory properties, impacting peripheral blood flow.