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Long-term propranolol therapy for angina pectoris

S G Warren, D L Brewer, E S Orgain

    The American Journal of Cardiology
    |March 4, 1976
    PubMed
    Summary
    This summary is machine-generated.

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    Propranolol effectively treats severe angina pectoris long-term, reducing mortality in patients with significant symptom relief. However, it may increase risks for heart failure and cardiogenic shock in specific patient groups.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Severe angina pectoris (New York Heart Association functional class III or IV) requires effective long-term management.
    • Propranolol is a beta-blocker used for cardiovascular conditions.

    Purpose of the Study:

    • To assess the long-term effectiveness and complication rate of propranolol in patients with severe angina.
    • To evaluate the impact of propranolol on mortality and adverse events over a 5 to 8-year follow-up period.

    Main Methods:

    • Prospective study of 63 patients with stable, severe typical angina pectoris treated with propranolol.
    • Follow-up period of 5 to 8 years, monitoring mortality, angina reduction, heart failure, and side effects.

    Main Results:

    • Average yearly mortality rate was 3.8%; cumulative 5-year mortality was 19%.

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  • A 50% or greater reduction in angina predicted a significantly lower mortality rate (P < 0.01).
  • Heart failure developed in 25% of patients; risk factors included prior congestive heart failure and cardiothoracic ratio > 0.5.

    • Conclusions:

    • Propranolol is an effective long-term therapy for severe angina, without inducing tachyphylaxis or increasing overall mortality.
    • Significant reduction in anginal pain with propranolol is a positive prognostic indicator.
    • History of congestive heart failure, cardiothoracic ratio > 0.5, and mild asthma are relative contraindications for propranolol therapy.