Nebivolol compared with metoprolol for erectile function in males undergoing coronary artery bypass graft

Abstract

Objective:The aim of this study was to evaluate erectile function in males undergoing coronary artery bypass graft (CABG) while on two different adrenoceptor beta-blocker regimens, namely nebivolol and metoprolol. We hypothesize that the negative effects of cardiopulmonary bypass on erectile function may be possibly attenuated by preferring a vasodilating selective β1-blocker, nebivolol, to metoprolol as an anti-ischemic and antiarrhythmic agent in males undergoing CABG.Methods:This randomized, double-blind, prospective clinical study was conducted in patients scheduled for CABG surgery between February 2012 and June 2014. A total of 60 consecutive patients who met inclusion criteria were randomized and divided into the following two groups: N group, which received 5 mg of nebivolol orally for 2 weeks before surgery plus 12 weeks after surgery or M group, which received 50 mg of metoprolol orally for the same period. All patients were evaluated by the erectile function domain of the International Index of Erectile Function-5 (IIEF-5) at the time of admission (before starting the beta-blocker) and 3 months after surgery.Results:In the metoprolol group, the mean IIEF-5 score decreased significantly from a baseline of 15.2±5.8 to 12.9±5.8 (p<0.001), but in the nebivolol group, this difference was not significant (from a baseline 12.9±5.5 to 12.4±5.5, p=0.053). In all patients, the mean IIEF-5 score decreased significantly from a baseline of 14.0±5.7 to 12.6±5.6 (p<0.001).Conclusion:Although erectile function in males undergoing CABG surgery decreases when metoprolol is used, nebivolol exerts protective effects on erectile function against the disruptive effects of cardiopulmonary bypass in patients undergoing CABG.

Clinical trials with nebivolol in Turkey

“…• SKB ve DKB'be benzer derece SolVH'de gerileme 5 mg (n=25) ayda azalma İrbesartan ekokardiyografik • Nebivolol ile SolVKİ'deki azalma 150 mg (n=28) değerlendirme 3. ayda anlamlı oluyor, Karvedilol diğerlerindeki 6. ayda anlamlı 25 mg (n=32) olmaya başlıyor • 12. aydaki azalma nebivolol ve karvedilol'de irbesartan'a göre daha fazla Aldemir ve ark. [7] Koroner baypas Çalışmanın kısıtlılığı: 1) Örneklem büyüklüğünün az olması ve statin tedavisi alanların değerlendirilmemesi 2) Nebivolol 5 mg'ın metoprolol için eşdeğer dozu 100 mg iken [2] bu çalışmada 50 mg metoprolol kullanılmış olması.…”

“…Aldemir ve ark., [7] nebivolol ve metoprolol'ün koroner baypas sonrası erektil fonksiyon üzerine etkisini randomize çift kör bir çalışmada karşılaştırmışlar. Bu amaçla koroner baypas olacak hastaların yarısı nebivolol 5 mg grubuna (n=30), diğer yarısı ise metoprolol 50 mg (n=30) grubuna randomize edilmiş.…”

Erectile dysfunction – overview from a cardiovascular perspective

“…Several studies reported impaired sexual function in patients taking beta blocker medication [29,30]. In patients with concomitant and indicated beta blocker therapy, switching to a novel third-generation β-1 blocker, e. g. nebivolol, with a greater degree of selectivity for β-1 adrenergic receptors is reasonable.…”

Heart rate recovery, cardiac rehabilitation, and erectile dysfunction in males with ischemic heart disease

“…It is well known that beta-blocker therapy effect might be different with regard to ED depending on sort of it in patients with IHD (4). Aldemir et al (4) have reported that although ED in males undergoing CABG surgery decreases when metoprolol is used, nebivolol had a protective effect on the sexual activity of men undergoing coronary artery bypass surgery with cardiopulmonary bypass.…”

“…Aldemir et al (4) have reported that although ED in males undergoing CABG surgery decreases when metoprolol is used, nebivolol had a protective effect on the sexual activity of men undergoing coronary artery bypass surgery with cardiopulmonary bypass. In addition, Brixius et al (5) have reported beneficial effects of nebivolol on the erectile function in hypertensive men.…”