Vasodilating beta-adrenoceptor blockers in post-myocardial infarction patients with type 2 diabetes

Results. Treatment that included β-AB in both groups showed comparable effects on blood pressure, heart rate, and anginal syndrome. During the follow-up in group A., compared with group B, the decrease in body mass index (by 6.6 and 1.45%), HbA1с (by 12.1 and 7.8%), the HOMA-IR index (by 29.2 and 18.8%), as well as the levels of total cholesterol, LDL cholesterol, blood triglycerides, and proteinuria were statistically significant, all p<0.05. Beneficial metabolic effects of treatment included vasodilating β-AB did not depend on the gender of patients, their age, initial values of HbA1c and lipid parameters, features of myocardial infarction, the presence and stage of arterial hypertension, heart failure, diabetic nephropathy, and the choice of a specific vasodilating β-AB (all p>0.05). Side effects of β-AB were observed in 16 (23.9%) cases (7 in group A and 9 in group B). No drug withdrawal was required in any of the cases. Conclusions. 1. Treatment with different β-AB was satisfactorily tolerated in post-myocardial infarction patients with DM2. Treatment with vasodilating and non-vasodilating β-AB, prescribed in addition to standard therapy, resulted in comparable hypotensive and antianginal effects, as well as a similar degree of heart rate reduction. In the group of patients who received vasodilating ß-AB, more pronounced beneficial effects of treatment were noted, including a more significant decrease in HbA1c, HOMA-IR index, total cholesterol, LDL cholesterol, triglycerides and proteinuria. Taking into account the better metabolic tolerability of vasodilating β-AB carvedilol and nebivolol, these β-AB agents may be preferred for patients with DM2 who have indication for β-AB use based on current recommendations.

type 2 diabetes mellitus, β-adrenergic blockers, carvedilol, nebivolol, myocardial infarction