title: The antioxidative effects of long-term treatment are more pronounced for carvedilol than for atenolol in post-myocardial infarction patients.
abstract: Oxidative stress might exert deleterious cardiovascular effects. The aim of the present study was to compare the antioxidative effects of carvedilol and atenolol. Levels of oxidized low-density lipoprotein cholesterol (ox-LDL), vitamin E, and thiobarbituric acid reactive substances (TBARS) were measured. In a prospective, open, and end-point-blinded study, 232 patients with an acute myocardial infarction (AMI) were randomized to receive either carvedilol or atenolol at equipotent doses, and the previously mentioned 3 parameters were measured at baseline and after 12 months of active treatment, with changes during the study period being compared both within and between the groups. Ox-LDL decreased in both treatment modalities, from 40.5 +/- 15.6 to 35.0 +/- 13.8 U/L, P = 0.0001, in the carvedilol group and from 40.3 +/- 16.5 to 37.4 +/- 13.1 U/L, P = 0.044, in the atenolol group, with a significant between-group difference in the changes (P = 0.036). The levels of vitamin E did not change during carvedilol treatment (31.0 +/- 10.2 vs 31.7 +/- 11.1 micromol/L), but it decreased marginally in the atenolol group (30.8 +/- 12.1 vs 27.2 +/- 9.1 micromol/L, P = 0.056), with a significant between-group difference (P = 0.008). No significant change in TBARS was observed between the carvedilol and atenolol groups (P = 0.454). These results indicate that carvedilol has a more pronounced antioxidative effect than atenolol in post-AMI patients, which might be of clinical importance.
authors.affiliation: Department of Cardiology, Ullevaal Hospital, University of Oslo, Oslo, Norway.
authors.forename: Gisli
authors.initials: G
authors.lastname: Jonsson
authors.forename: Michael
authors.initials: M
authors.lastname: Abdelnoor
authors.forename: Ingebjorg
authors.initials: I
authors.lastname: Seljeflot
authors.forename: Harald
authors.initials: H
authors.lastname: Arnesen
authors.forename: Arne T
authors.initials: AT
authors.lastname: Hostmark
authors.forename: Sverre E
authors.initials: SE
authors.lastname: Kjeldsen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Os
authors.forename: Arne S
authors.initials: AS
authors.lastname: Westheim
mesh_terms: D000975:Antioxidants / Q000494:pharmacology*; D001262:Atenolol / Q000494:pharmacology*; D002227:Carbazoles / Q000494:pharmacology*; D000077261:Carvedilol; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D011412:Propanolamines / Q000494:pharmacology*; D011446:Prospective Studies; D013995:Time
chemical_list: D000975:Antioxidants; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D001262:Atenolol