Clinical Trial: Comparison of Carvedilol and Atenolol on Anti-anginal and Metabolic Effects in Patients With Stable Angina Pectoris
Study Status: Completed
Recruit Status: Completed
Study Type: Interventional
Official Title: Comparison of Carvedilol and Atenolol on Anti-anginal and Metabolic Effects in Patients With Stable Angina Pectoris
Brief Summary: There are few data regarding anti-anginal effects between beta-blockers with and without vasodilating property. Beta-blocker without vasodilating property is generally known to have unfavorable effects on glucose and lipid metabolism. Therefore, the investigators compared carvedilol and atenolol on anti-anginal and metabolic effects in patient with stable angina pectoris.
Detailed Summary: Previous studies have demonstrated that beta-blockers are effective in reducing not only ischemia but also cardiovascular mortality following myocardial infarction. And, recent guidelines have suggested the potential for use of beta-blockers as first-line agents in chronic stable angina. However, beta-blockers are a diverse class with different mechanisms of action and physiological effects. Various pharmacologic properties that characterize beta-blockers include cardioselectivity, intrinsic sympathomimetic activity, and concomitant vasodilating alpha-adrenoceptor blockade, which might exhibit differential anti-anginal efficacies. In addition, traditional beta-blockers, particularly nonvasodilating beta-blockers, have been reported to have negative metabolic effects, including hyperglycemia, insulin resistance, and dyslipidemia. These unfavorable effects of beta-blockers should be considered in patients with stable angina pectoris, because the pathophysiology of coronary artery disease is associated with abnormalities in glucose and lipid metabolism. Carvedilol, a newer vasodilating beta-blocker, has been shown to differ from traditional beta-blockers in terms of metabolic effects in patients with hypertension and diabetes. However, few data regarding comparative anti-anginal and metabolic effects between beta-blockers with and without vasodilating property have been reported, particularly in patients with angina pectoris. In this study, we simultaneously compared anti-anginal and metabolic effects of carvedilol and atenolol in patients with stable angina pectoris.
Sponsor: Gachon University Gil Medical Center
Current Primary Outcome:
- Time to 1-mm ST-segment depression [ Time Frame: After 25 weeks of treatment ]Time to 1-mm ST-segment depression at exercise treadmill test
- Time to onset of angina [ Time Frame: After 25 weeks of treatment ]Time to onset of angina at exercise treadmill test
Original Primary Outcome: Same as current
Current Secondary Outcome:
- Blood pressure at resting and peak exercise [ Time Frame: After 25 weeks of treatment ]Blood pressure at resting and peak exercise during exercise treadmill test
- Heart rate at resting and peak exercise [ Time Frame: After 25 weeks of treatment ]Heart rate at resting and peak exercise during exercise treadmill test
- Lipid profiles [ Time Frame: After 25 weeks of treatment ]Lipid profiles: total cholesterol, triglyceride, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol
- Glucose metabolism [ Time Frame: After 25 weeks of treatment ]Fasting glucose, insulin, HbA1c, Quantitative Insulin-Sensitivity Check Index (QUICKI)
- Seattle Angina Questionnaire (SAQ) scores [ Time Frame: After 25 weeks of treatment ]
- Treatment-emergent adverse events [ Time Frame: After 25 weeks of treatment ]
Original Secondary Outcome: Same as current
Information By: Gachon University Gil Medical Center
Dates:
Date Received: September 9, 2015
Date Started: April 2011
Date Completion:
Last Updated: September 10, 2015
Last Verified: September 2015