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

Q: What are the key findings of this study?

Metoprolol and bisoprolol both improved LVEF (+7.09% vs +4.23%, p=0.20) and QoL (p=0.70) in CAD patients, with significant between-group differences in SBP (p=0.041), DBP (p<0.001), and HR (p=0.028).

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery disease (n=60). Intervention: Metoprolol vs. Bisoprolol. Primary outcome: Change from baseline in Left Ventricular Ejection Fraction (LVEF, %) (p=0.20).

Q: What does this research mean for the field?

Both metoprolol and bisoprolol significantly improve blood pressure, heart rate, left ventricular ejection fraction, and quality of life in coronary artery disease patients, with comparable improvements in cardiac function and quality of life. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Guttula Divya Sai Sri; Retesh Paul; Lakshmi Himaja Bandaru; Suvam Sinha; Gnanendra Sai Kumar Nareboina; Ramam Sripada; V. Revanth; M D Dhanaraju

doi:10.63001/tbs.2026.v21.i04.pp87-90

October 4, 2026The Bioscan.Open Access

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

View Full Paper

Ask AI

Bookmark

Share

Key result

Metoprolol and bisoprolol both improve LVEF similarly in CAD, but differ in hemodynamic effects.

P=0.20
n=60

Why the study?

Beta-blockers are the most commonly prescribed class of drugs in CAD, and this study directly compared the effects of metoprolol and bisoprolol in patients with CAD.

Does metoprolol compared with bisoprolol improve blood pressure, heart rate, left ventricular ejection fraction, regional wall motion abnormalities, and quality of life in patients with coronary artery disease?

Key Points

To directly compare the therapeutic effects of metoprolol and bisoprolol on blood pressure, heart rate, left ventricular ejection fraction, regional wall motion abnormalities, and quality of life in patients with coronary artery disease.
Prospective comparative, non-randomized single-centre study conducted over 6 months at KIMS Hospital in India involving 60 adult patients diagnosed with coronary artery disease.
Patients received either metoprolol (N=30) or bisoprolol (N=30), with baseline and post-treatment assessments of systolic blood pressure, diastolic blood pressure, heart rate, left ventricular ejection fraction (LVEF), regional wall motion abnormalities (RWMA), and WHOQOL-BREF scores.
Statistical evaluations utilized paired and independent t tests for continuous physiological variables and exact McNemar tests for paired RWMA binary outcomes.
Systolic blood pressure and heart rate decreased significantly in both cohorts, whereas diastolic blood pressure decreased significantly only with bisoprolol; between-group changes were significant for systolic blood pressure (p = 0.041), diastolic blood pressure (p <0.001), and heart rate (p = 0.028).
LVEF showed significant within-group improvements from 44.87% to 51.96% with metoprolol (p <0.001) and from 40.57% to 44.80% with bisoprolol (p = 0.030), with no significant difference between groups (p = 0.20).
Quality of life scores significantly improved in both groups (mean gain 9.48 with metoprolol vs 8.88 with bisoprolol; p = 0.70 between groups), while regional wall motion abnormalities showed no statistically significant change (metoprolol p = 0.250, bisoprolol p = 1.000).

Study Design

Type

Observational (n=60)

Blinding

Open-label

Randomization

Non-randomized

Multicenter

No

Structured PICO

Does metoprolol compared with bisoprolol improve blood pressure, heart rate, left ventricular ejection fraction, regional wall motion abnormalities, and quality of life in patients with coronary artery disease?

P

Population

60 adults (mean age 56.5 years, 36.7% female) in India with coronary artery disease, free of severe renal or respiratory comorbidities, followed in a 6-month prospective comparative study.

E

Exposure

Metoprolol (n=30, dose, frequency, and route not stated)

C

Comparator

Bisoprolol (n=30, dose, frequency, and route not stated)

O

Outcome

Changes from baseline to post-treatment in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), left ventricular ejection fraction (LVEF), regional wall motion abnormalities (RWMA), and overall quality of life (QoL) scores measured using the 26-item WHOQOL-BREF questionnairesurrogate

Main Result

Absolute Event Rate: 7.09% vs 4.23%

p-value: p=0.20

Limitations

Relatively small sample size (N=60)
Non-randomized treatment allocation
Potential confounding from differences in baseline characteristics, concomitant medications, and disease severity
Single-centre design
Relatively short follow-up duration
Relatively small study sample
Differences in baseline characteristics, concomitant medications, and disease severity may have influenced the findings
Relatively short follow-up

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

In this small prospective non-randomized study of patients with coronary artery disease, both metoprolol and bisoprolol significantly improved left ventricular ejection fraction and quality-of-life scores to a similar degree, though bisoprolol produced greater reductions in blood pressure while metoprolol produced a slightly greater reduction in heart rate.

Abstract

Background: Beta-blockers are the most commonly prescribed class of drugs in coronary artery disease (CAD). This studydirectly 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 receivingbisoprolol. Clinical parameters such as systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), leftventricular ejection fraction (LVEF), regional wall motion abnormalities (RWMA), and quality of life (QoL) scores weremeasured 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 bisoprololgroup. 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 whileRWMA remained unchanged across both treatment groups.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Sri et al. (2026) conducted an observational in Coronary artery disease (n=60). Metoprolol vs. Bisoprolol was evaluated on Change from baseline in Left Ventricular Ejection Fraction (LVEF, %) (p=0.20). Metoprolol and bisoprolol both improved LVEF (+7.09% vs +4.23%, p=0.20) and QoL (p=0.70) in CAD patients, with significant between-group differences in SBP (p=0.041), DBP (p<0.001), and HR (p=0.028).

synapsesocial.com/papers/6af3463ebdf2424ebd04f86c https://doi.org/10.63001/tbs.2026.v21.i04.pp87-90

View Full Paper

Ask AI

Bookmark

Share

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

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading