Over the last decade, a growing number of pre-clinical studies have provided evidence to suggest that beta-blockers may have an antiatherosclerotic effect 54-56 . The first clinical data supporting the antiatherosclerotic potential of beta-blockade have recently emerged from two complementary, double-blind, placebo-controlled 3-year ultrasound studies with Seloken® ZOK :
BCAPS - Beta-Blocker Cholesterol-Lowering Asymptomatic Plaque Study
The aim of BCAPS was to compare the effects of low dose Seloken ZOK (25 mg once daily) and fluvastatin (40 mg once daily) on the progression of carotid intima media thickness (IMT) over a 36-month period in a large, factorial design study of 793 subjects who had carotid plaque, but no symptoms of carotid artery disease. In addition, the incidence of myocardial infarction and stroke were recorded over the treatment period. The results show that Seloken ZOK significantly reduced the rate of progression of carotid IMT in healthy, symptom-free subjects with carotid plaque. Moreover, the findings also indicated a beneficial effect on the combined endpoint of mortality and cardiovascular events, including myocardial infarction and stroke 52 .
In BCAPS, Seloken ZOK 25 mg once daily significantly reduced plaque thickness during follow-up (measured as maximum intima media thickness in the carotid bulb at 18 and 36 months) 52 .
ELVA – Effect of Long-term treatment of metoprolol CR/XL on surrogate Variables for Atherosclerotic disease
The aim of the ELVA study was to test the hypothesis that treatment with Seloken ZOK 100 mg once daily provides additional antiatherosclerotic effect (as measured by intima media thickness) in patients with hypercholesterolaemia receiving concomitant lipid-lowering therapy (mainly a statin). The study included 92 men and women with severe hypercholesterolaemia and signs of early atherosclerosis in the right carotid artery. The results show a highly significant difference between the Seloken ZOK and placebo groups in the rate of progression of the composite variable, carotid bulb intima media thickness and common carotid intima media thickness (p=0.004 at 12 months), which was sustained after 3 years of follow-up (p=0.011) 53 .
The ELVA study with Seloken ZOK 100 mg once daily provides the first clinical data from patients with hypercholesterolaemia to show an antiatherosclerotic effect of beta-blockade as additional therapy to statins.
