The Differential Effects of Carvedilol and Atenolol on Lipid Metabolism in Patients with Stable Angina

초록

Background: Beta-blocker is generally known to have unfavorable effects on glucose and lipid metabolism. We compared the effects of carvedilol with those of atenolol in patient with stable angina (SA). Methods: A total of 37 patients (mean age, 54.1±9.0 years; male, 54%) with stable angina were randomly assigned to carvedilol (n=18) or atenolol (n=19) for 6 months. Exercise treadmill test and Seattle Anigna Questionnaire (SAQ) was performed and metabolic and inflammatory parameters were measured at baseline and 6 months. Results: Time to ST-segment depression during treadmill and the SAQ scorings were improved after treatment to a similar extent in both groups. There was no significant change from baseline on fasting glucose, insulin or HbA1c in both groups. However, total cholesterol was significantly reduced to a greater extent with carvedilol therapy compared to atenolol therapy (-25% vs. −11%, respectively, P=0.010), although the rate of statin use was similar (83.3% vs. 84.2%, respectively, P=1.000). The carvedilol group had a trend for more reduction of LDL-cholesterol than that of atenolol group (-42% vs. −28%, respectively, P=0.081). In addition, there was a trend toward reduction of hs-CRP in the carvedilol group (0.9 [0.5-1.66] to 0.4 [0.2-1.0] mg/L, P=0.058), but not in the atenolol group (0.7 [0.2-2.7] to 0.6 [0.2-1.0] mg/L, P=0.776). Conclusions: Carvedilol might have more favorable effects on lipid metabolism and inflammation in patients with SA, compared with those of atenolol.