Comparison of the antianginal efficacy of acebutolol and propranolol. A multicenter, randomized, double-blind placebo-controlled study.

Publisher Website
Google Scholar
Abstract
The effects of oral acebutolol, a cardioselective .beta.-adrenergic blocking agent with partial agonist activity were compared with those of oral propranolol, a noncardioselective agent devoid of partial agonist activity, on the exercise tolerance and anginal pattern in 46 male patients with chronic stable angina pectoris. A 28-wk, multicenter, placebo-controlled, randomized, double-blind, crossover study design was used. Each double-blind treatment phase was followed by a 2-wk gradual drug-withdrawal phase and a placebo-controlled drug-free week. Angina frequency, nitroglycerin consumption and symptom-limited exercise tests were assessed throughout the study. Acebutolol and propranolol produced compared levels of .beta. blockade at 1650 .+-. 375 mg/day and 219 .+-. 50 mg/day (mean .+-. SD), respectively, as confirmed by a significant reduction in resting and peak exercise heart rates and rate-pressure products. Compared with placebo (acebutolol vs. propranolol, NS [not significant]), acebutolol produced a greater reduction in systolic, mean and diastolic blood pressures and a smaller reduction in resting heart rate than propranolol, presumably reflecting its partial agonist and cardioselective properties during similar dose-titration phases. Exercise duration and exercise work improved similarly with each agent. Acebutolol and propranolol significantly and comparably reduced anginal frequency (56% and 54%, respectively, P < 0.001) and weekly nitroglycerin consumption (57% and 47%, respectively, P < 0.01) compared with placebo. No clinical or laboratory side effects of acebutolol or propranolol necessitated drug withdrawal. Acebutolol is a well-tolerated and safe .beta.-adrenergic blocking agent that possesses cardioselective and mild intrinsic sympathomimetic activities and compares favorably with propranolol in antianginal efficacy in patients with chronic stable angina.