Angiographic evolution of coronary atherosclerosis in patients receiving propranolol. A two-year follow-up.
OBJECTIVE
To test whether propranolol may influence the progression of coronary atherosclerosis.


METHODS
Repeat coronary angiography after two year treatment and evaluation of changes in coronary narrowings.


METHODS
Subjects with effort angina of recent onset requiring coronary angiography and medical treatment.


METHODS
80 untreated patients, with a greater than or equal to 50 percent focal narrowing on a major coronary branch associated or not with a less than 50 percent stenosis of other major branches. They were randomized to isosorbide dinitrate (40 mg bid) (group 1, control group) or to propranolol (80 mg qid) (group 2, treatment group).


RESULTS
At restudy, there were more diseased vessels and These narrowings per patient in both groups. Multivessel involvement and greater than or equal to 50 percent obstructions were also augmented. These changes were not statistically significant. Patients with progression of the stenotic tracts (both greater than or equal to 50 percent and less than 50 percent were 19 (48 percent) in group 1 and 28 (70 percent) in group 2 (p less than 0.05). Narrowings with progression were 25 in group 1 and 48 in group 2. Thirteen narrowings in group 1 and 15 in group 2 were newly detected at restudy. Eighteen patients (45 percent) in group 1 and nine (23 percent) in group 2 had a steady disease. Smoking, high blood pressure, family history of coronary disease, blood glucose values and lipid levels were considered; the only significant group differences were 31 percent rise of total triglyceride and 23 percent decrease of HDL cholesterol in patients who were treated with propranolol.


CONCLUSIONS
Propranolol showed an adverse influence on coronary atherosclerosis, regarding the evolution of both greater than or equal to 50 percent and less than 50 percent narrowings and not the formation of new stenoses. Changes in serum lipid values might have a role.
Loaldi
A
A
Istituto di Cardiologia, University of Milan, Italy.
Montorsi
P
P
Fabbiocchi
F
F
Polese
A
A
Guazzi
M
M
De Cesare
N
N
Guazzi
M D
MD
D000787:Angina Pectoris / Q000188:drug therapy*; D015901:Angiography, Digital Subtraction; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use*; D013997:Time Factors
D011433:Propranolol; D007548:Isosorbide Dinitrate