Comparative evaluation of the effectiveness of metoprolol succinate and metoprolol tartrate in patients with vasospastic angina

Rationale. The search for a more effective therapy for vasospastic angina pectoris, taking into account clinical and economic indicators.

Objective. To compare the clinical and economic efficiency of therapy with metoprolol tartrate and metoprolol succinate in patients with vasospastic angina.

Materials and methods. A randomized study involving 77 patients with a follow-up period of 12 months was conducted. The results were compared in terms of antianginal efficacy parameters between a group of patients (n = 41) with vasospastic angina pectoris who received metoprolol tartrate (Еgilok at a dose of 25 mg 2 times a day) for standard therapy with a calcium antagonist (Norvasc), with a similar group of patients (n = 36) who received metoprolol succinate (Betaloc ZOK 50 mg). The primary endpoints were cardiovascular death, development of AMI, stroke, secondary endpoints — the number of clinically significant angina attacks, patients were followed up for 12 months (over 15 minutes, cases requiring hospitalization or calling an ambulance team).

Results. During the observation period, a significant difference was obtained in the incidence of clinically significant angina attacks (p = 0.043) with an advantage in the group of patients receiving metoprolol succinate. According to the primary endpoints, there was no significant difference in the groups of metoprolol tartrate and succinate: in the number of cardiovascular mortality (p = 0.94), development of AMI (p = 0.89), stroke (p = 0.53).

Conclusion. There are no significant differences in the incidence of adverse cardiovascular events, such as AMI, stroke, including those leading to death in the groups of patients with vasospastic angina taking metoprolol tartrate or succinate. However, there is a significant difference in the incidence of clinically significant anginal attacks with the advantage of succinate salt. Metoprolol tartrate has great pharmacoeconomic advantages.

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