TREATMENT OF CHRONIC STABLE ANGINA WITH CELIPROLOL

Celiprolol is a third generation beta blocking drug with intrinsic vasodilator effect. We evaluated the effect of this drug at a fixed dose of 400 mg daily in 20 patients with coronary artery disease and stable angina having 2 to 40 episodes of pain a week. All patients had positive exercise stress test with > 1 mm ST depression. Compared to the 1 month baseline placebo phase, patients after 3 months of treatment with celiprolol had less episodes of angina (2.4 vs 7.2 a week, p < 0.001), higher angina threshold (667 vs 337 sec, p < 0.025), higher ischemia threshold (614 vs 401 sec, p < 0.001) and were able to perform more work (3937 vs 2403 kgm/min. p < 0.01). 9 patients had no pain during exercise. A decrease in blood pressure, heart rate and double product was evident in the stress tests of the active phase. Adverse effects included headache (4 patients), sweating (1) and fatigue (1) not requiring modification of drug dose. No adverse effects were seen in 13 patients. Thus, celiprolol is effective to decrease angina during daily life and increase excercise tolerance in patients with chronic stable angina pectoris.