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The long-term effects of metoprolol and epanolol on tissue-type plasminogen activator and plasminogen activator inhibitor 1 in patients with ischaemic heart disease


This double-blind, randomized parallel group study investigated the effect of 6 months β-adrenoceptor antagonist therapy with either metoprolol (β1-selective without intrinsic sympathomimetic activity [ISA]) or epanolol (β1-selective with ISA) on markers of endogenous fibrinolysis in 20 patients with chronic stable angina receiving concurrent treatment with nifedipine.

Neither drug had an effect on tissue-type plasminogen activator or plasminogen activator inhibitor type 1 (PAI-1). A significant correlation between fasting insulin and PAI-1 has previously been described and was confirmed in this study. The group treated with metoprolol showed a significant rise in fasting insulin after 6 months with no change in PAI-1.

This suggests that the previously described link between these two may not be causal.

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Correspondence to R. A. Wright.

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Wright, R.A., Perrie, A.M., Stenhouse, F. et al. The long-term effects of metoprolol and epanolol on tissue-type plasminogen activator and plasminogen activator inhibitor 1 in patients with ischaemic heart disease. Eur J Clin Pharmacol 46, 279–282 (1994). https://doi.org/10.1007/BF00192563

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Key words

  • Metoprolol
  • Epanolol
  • Ischaemic heart disease
  • tissue-type plasminogen activator
  • plasminogen activator inhibitor type 1