[Effects of a superselective beta1-adrenoblocker nebivolol on the course of coronary heart disease and insulin resistance in patients with diabetes mellitus type 2 after coronary artery bypass grafting].
OBJECTIVE
To study safety and effects of nebivolol on the course of coronary heart disease (CHD) and insulin resistance (IR) in patients with diabetes mellitus type 2 (DM-2) after coronary artery bypass grafting.


METHODS
The study included 53 CHD patients with DM-2 (mean age 56.7 +/- 1.3 years). All the patients were divided into two groups: 22 patients with IR (group 1) and 31 patients free of IR (group 2). All the patients received an 8 week course of nebivolol the efficacy of which was assessed by changes in coronary failure, exercise tolerance, quality of life, lipid and carbohydrate metabolism.


RESULTS
In group 1 an antianginal effect of nebivolol manifested with less frequent (by 54.7%) development of angina pectoris (p = 0.0003), a 59.8% (p = 0.0004) decrease in 24-h need in nitroglycerine. In group 2 these reductions were 63.4 and 61.6% (p < 0.01), respectively. Exercise tolerance increased by 36.2 and 25.2%, left ventricular ejection fraction significantly increased by 5.9 and 5%, respectively, quality of life improved by 25 and 23%, respectively. As a result, a functional class of chronic cardiac failure lowered. Nebivolol had no negative effect on compensation of blood lipid and carbohydrate metabolism. A trend to blood insulin fall by 18.4% was found. IR index diminished by 11.9%.


CONCLUSIONS
Administration of nebivolol in a dose 1.25-5 mg/day raised exercise tolerance, improved quality of life, reduced IR index by 11.9%, triglycerides level by 5.3%. This lowered the risk of effects of diabetic atherogenic dyslipidemia.
Tepliakov
A T
AT
Kuznetsova
A V
AV
Lukinov
A V
AV
Levshin
A V
AV
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001578:Benzopyrans / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D004983:Ethanolamines / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D000068577:Nebivolol; D010975:Platelet Aggregation Inhibitors; D011788:Quality of Life; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D001578:Benzopyrans; D001786:Blood Glucose; D004983:Ethanolamines; D007328:Insulin; D010975:Platelet Aggregation Inhibitors; D000068577:Nebivolol