Metoprolol versus Bisoprolol in Patients with Coronary Artery Disease: A Prospective Comparative Study

Abstract

Background: Beta-blockers are the most commonly prescribed class of drugs in coronary artery disease (CAD). This study
directly compared the effects of on metoprolol and bisoprolol in patients with CAD.
Methods: This prospective comparative study included 60 patients with CAD, with 30 receiving metoprolol and 30 receiving
bisoprolol. Clinical parameters such as systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), left
ventricular ejection fraction (LVEF), regional wall motion abnormalities (RWMA), and quality of life (QoL) scores were
measured before and after treatment. Statistical analysis included both paired and independent t tests for continuous variables,
and performed McNemar test for paired RWMA data.
Results: Both groups showed significant reductions in SBP and HR while DBP declined significantly only in the bisoprolol
group. Between group differences revealed significant for changes in SBP, DBP, and HR (p = 0.041, <0.001, and 0.028,
respectively). LVEF improved in both cohorts rising from 44.87% to 51.96% with metoprolol and from 40.57% to 44.80%
with bisoprolol. QoL scores increased in both groups, without a significant difference (p = 0.70).
Conclusion: Metoprolol and bisoprolol both produced significant improvements in BP, HR, LVEF and QoL scores while
RWMA remained unchanged across both treatment groups.