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Long-term treatment with low-dose metoprolol CR/XL is associated with increased plaque echogenicity: The Beta-blocker Cholesterol-lowering Asymptomatic Plaque Study (BCAPS).

  • Gerd Östling
  • Isabel Goncalves
  • John Wikstrand
  • Göran Berglund
  • Jan Nilsson
  • Bo Hedblad
Publishing year: 2011
Language: English
Pages: 440-445
Publication/Series: Atherosclerosis
Volume: 215
Document type: Journal article
Publisher: Elsevier

Abstract english

OBJECTIVES: To examine whether the decrease in IMT progression rate in the carotid bulb induced by metoprolol CR/XL treatment (25mg once daily) observed in the β-blocker Cholesterol-lowering Asymptomatic Plaque Study (BCAPS) was accompanied by an effect on carotid plaque echogenicity. METHODS: Gray scale median (GSM) in carotid plaques, used as a score of echogenicity, was measured at baseline and after 36 months in those 341 subjects (aged 49-69 years) with an asymptomatic moderate- to large-sized carotid plaque present at baseline and at follow-up. Participants were in a factorial design assigned to treatment with metoprolol CR/XL (25mg once daily), fluvastatin (40mg once daily) or corresponding placebo. RESULTS: After 36 months plaques were more echogenic in participants treated compared to those not treated with metoprolol CR/XL (57.3±16.8 versus 51.8±20.0, p=0.006). GSM had increased more from baseline in the metoprolol CR/XL treated subjects (25±15 versus 18±20, p<0.001), and plaques that had become more echolucent were less frequent in the metoprolol CR/XL treated subjects (3.6% versus 17.0%, p<0.001). CONCLUSIONS: Long-term treatment with low dose metoprolol CR/XL in clinically healthy subjects with moderate-sized carotid plaques was associated with increase in plaque echogenicity, suggesting a potential beneficial effect of the β-blocker treatment on plaque stability.


  • Cardiac and Cardiovascular Systems


  • Internal Medicine - Epidemiology
  • Cardiovascular Research - Immunity and Athersosclerosis
  • Cardiovascular Research - Epidemiology
  • ISSN: 1879-1484
E-mail: jan [dot] nilsson [at] med [dot] lu [dot] se

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