[Experience with the superselective third-generation beta-adrenoblocker nebivolol used to treat patients with prior myocardial infarction].
The effectiveness and safety of therapy with nebivolol and its effects on life quality (LQ) were studied in 71 patients with prior myocardial infarction (MI) with an ejection fraction of 40% or more. The follow-up lasted 1 year. The mean daily dose of the drug was 3.66 +/- 0.11 mg. Echocardiography, bicycle ergometry, daily ECG monitoring, survey according to the questionnaires developed by V. P. Zaitsev, a researcher of All-Russian Cardiology Research Center, Russian Academy of Medical Sciences, to the depression scale (DS), the personality scale (PS) and reactive anxiety scale (RAS) by Spilberg-Khanin were performed. The study was conducted on the day of initiation of outpatient treatment, following 3 months and 1 year. After 3 months of therapy, clinical improvement was observed in 83% of the patients and it preserved at the same level till the end of the first year: exercise tolerance and the total volume of work increased significantly (p < 0.001), 97% of the examinees returned to work. Nebivolol produced an antiarrhythmic effect in 66.7% of the patients with high Lown gradation premature beats. Therapy with the agent showed a low mortality rates (1.4%), few number of cardiovascular excesses (4.2%), and good tolerability (7.2%). By the end of the first year, cardiac remodeling improved insignificantly: end-systolic volume, end-diastolic volume, left ventricular myocardial mass decreased by 6.4, 1.4, and 7%, respectively; fraction ejection increased by 2.3% of the baseline values. The parameters of LQ improved: the RAS scores reduced by 18.4%; the number of patients with high PS scores decreased significantly (p < 0.05) due to the increase in the number of patients with its moderate level (p < 0.01) and, what is significant, erectile function did not deteriorate. Thus, nebivolol demonstrated its high effectiveness and safety during prolonged therapy of patients with prior MI, without cardiodepressive activity and favorable impact on their LQ.
Bichan
N A
NA
Bykova
E F
EF
Gorbatovskiĭ
Ia A
IaA
Pakhtusova
N I
NI
Mishchenko
E P
EP
Onishchenko
E G
EG
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001578:Benzopyrans / Q000008:administration & dosage / Q000627:therapeutic use*; D004562:Electrocardiography; D004983:Ethanolamines / Q000008:administration & dosage / Q000627:therapeutic use*; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D000068577:Nebivolol; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D001578:Benzopyrans; D004983:Ethanolamines; D000068577:Nebivolol