A Retrospective Evaluation of Heart Rate Control of Nebivolol Compared to Bisoprolol in Patients with Coronary Slow-flow Syndrome

The coronary slow flow phenomenon (CSFP) describes a slow progression of contrast medium in filling the coronary arteries during coronary angiography. Patients have limitations in their daily activities and other co-morbid health issues that impair their quality of life. Beta-blockers are used to control the heart rate (HR) in adult patients with CSF. This study aimed to, retrospectively, investigate the effectiveness of nebivolol compared to bisoprolol in controlling HR in adult patients with CSFP. The study was performed using the medical registry, from January 2019 to December 2021, of Dr. Sulaiman Al Habib Hospitals, Riyadh, Saudi Arabia, for patients diagnosed with CSF. The study consisted of two groups of patients using either 5mg nebivolol or 5mg bisoprolol orally once per day. The study involved a cohort of 270 patients grouped into two; 135 in the nebivolol group and 135 in the bisoprolol group. The primary outcome in this study was the HR control measured at 12-h and 24-h post medication administration. For the bisoprolol group, the readings for mean HR +/- SD were; 99.4 +/- 11.07, 74.27 +/- 12.43, and 75.17 +/- 11.74 for the baseline HR, 12 hs-HR and 24 h-HR. respectively. For the nebivolol group, the readings for mean HR +/- SD were; 101.94 +/- 12.74, 73.50 +/- 11.3, and 74.27 +/- 12.43 for the baseline HR, 12 hs-HR and 24 h-HR. There was no significant difference in the mean HR after 12 h and 24 h between the two groups; p-value = 0.69 and 0.584, respectively. Findings from the present study showed that nebivolol and bisoprolol have comparable effectiveness in controlling HR in patients with CSF. Further studies are needed to assess the long-term effect of both medications in this category of patients.