After myocardial infarction carvedilol improves insulin resistance compared to metoprolol
- 101 Downloads
Both carvedilol and metoprolol have cardioprotective effects and decrease infarct size in myocardium. We compared effects of carvedilol and metoprolol on insulin resistance and serum lipid levels after myocardial infarction.
Fiftynine patients aged between 30 and 70 and BMI = 25–30 kg/m2, who were diagnosed with myocardial infarction with ST segment elevation, were considered to be eligible for the study. Patients were randomly allocated to two different therapy protocols. Metoprolol 100 mg bid or carvedilol 25 mg bid was added to their standardized therapy regimen. Baseline to week 4 and 12, fasting blood glucose, serum lipid profile, BMI, C–peptide, insulin and homeostasis model assessment of insulin resistance (HOMA–IR) were measured.
After 12 weeks of metoprolol therapy HOMA–IR, insulin and C–peptide levels were significantly higher (p<0.05 for all) and total cholesterol and triglyceride levels decreased significantly (p < 0.05 for all) compared to baseline. After 12 weeks of carvedilol therapy HOMA–IR, insulin and C–peptide (p < 0.05 for all), total cholesterol and triglyceride (p = 0.001 for all) decreased significantly compared to baseline. Carvedilol provided more decrease in total cholesterol and LDL levels than metoprolol (p = 0.043 and p = 0.021, respectively).
In patients after myocardial infarction, carvedilol added to background therapy improved insulin resistance and lipid profile.
Key wordsMyocardial infarction carvedilol metoprolol insulin resistance
Unable to display preview. Download preview PDF.
- 3.Bakris GL, Fonseca V, Katholi RE et al. GEMINI Investigators (2004) Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomized controlled trial. JAMA 10:2227–2236Google Scholar
- 6.De Fronzo RA, Ferrannini E (1991) Insulin resistance a maltifaceted syndrome responsible for NIDDM, obesity, hypertension and dyslipidemia. Diab Care 14:173–177Google Scholar
- 7.Freemantle N, Cleland J, Young P et al. (1999) Beta blockade after myocardial infarction: systematic review and meta regression analysis. BMJ 26:1730–1737Google Scholar
- 10.Jacob S, Balletshofer B, Henriksen EJ et al. (1999) Beta–blocking agents in patients with insulin resistance: effects of vasodilating beta blockers. Blood Pres 8:261–268Google Scholar
- 14.Otterstad J, Ford I (2002) The effect of carvedilol in patients with impaired left ventricular systolic function following an acute myocardial infarction. How do the treatment effects on total mortality and recurrent myocardial infarction in CAPRICORN compare with previous beta blocker trials? Eur J Heart Fail 4:501PubMedGoogle Scholar
- 17.Reaven GM (1998) Role of insulin resistance in human disease. Diabetes 37:1595–1607Google Scholar
- 21.Sekiguchi M, Kurabayashi M, Adachi H et al. (2004) Usefulness of insulin resistance measured by homeostasis model assessment in predicting restenosis after coronary stent placement in nondiabetic patients. Am J Cardiol 93:920–922Google Scholar