P.026 Clinical and Vascular Effects of Switching Patients with Coronary Artery Disease to Nebivolol

Abstract

The problem of inadequate efficacy of standard antianginal therapy in patients with stable angina requires new pharmacotherapeutic solutions.

Aim

Evaluating efficiency of antianginal therapy with b-adrenoblockers (BAB) in patients with stable angina during the switch to nebivolol; evaluating the dynamics of vasculature functional state and concentration of NO metabolites during the nebivolol treatment.

Materials and methods

Open-label observational study was conducted on 30 patients with II-III FC angina. Prior to the nebivolol administration and also after 12 weeks of treatment, in addition to the evaluation of clinical state and nebivolol tolerance. The assessment of arterial stiffness was done by way of measuring brachial-ankle pulse wave velocity (baPWV). A new parameter presenting stiffness of the vascular wall independent on the BP dynamics. Endothelial function was calculated based on flow-mediated dilatation (FMD) parameters. Serum nitrate and nitrite as NO metabolic products were measured.

Results

After 12 weeks of the nebivolol therapy, the rate of anginal attacks significantly decreased by 60%, and nitroglycerin (NG) intake reduced by 75% as compared to the previous treatment. Switching the patients to nebivolol was associated with a significant decrease in baPWV by 6.1% while FDV increased by 27%. Serum level of NO metabolites increased by 47%.

Conclusion

The nebivolol treatment was generally well tolerated and lead to significant patient condition improvement. This effect of nebivolol of should be attributed to baPWV lowering and endothelial function bettering.