990-53 Effects on Cardiovascular End Points and Psychological Variables of Metoprolol and Verapamil in Patients with Stable Angina Pectoris — The Angina Prognosis Study in Stockholm (APSIS)

The effect of treatment with metoprolol or verapamil was investigated in 809 patients with stable angina pectoris. End points for the study were: death, nonfatal cardiovascular events and three psychological variables reflecting aspects of quality of life. Nonfatal cardiovascular events included acute myocardial infarction, incapacitating or unstable angina, cerebrovascular and peripheral vascular events. The psychological variables were aggregate measures of psychosomatic symptoms and sleep disturbances and an evaluation of life satisfaction on a visual analogue scale. The mean age of the patients was 59±7 years and 30% were women. The patients were followed for a total of 2887 patient years, with a median follow-up time of 3.6 years. Total cardiovascular mortality in the metoprolol versus verapamit group were 5.4% versus 6.2% and 4.7% versus 4.7% respectively. Nonfatal cardiovascular events occurred in 26.4 and 24.1%, respectively. Psychosomatic symptoms and sleep disturbances were significantly improved in both treatment groups. The magnitude of change was small and not significantly different. Life satisfaction did not change on either drug. Withdrawals due to side effects occurred in 11.1 and 14.6%, respectively.ConclusionThis large scale long term study shows that both drugs were well tolerated and had the same effect on mortality, cardiovascular end points and measures of quality of life