Pharmacological treatment during AMI and in secondary prevention: the scientific evidence

Table 5. Calcium-antagonists. Effect on mortality.
STUDY DRUG No. PATIENTS FOLLOW-UP VAR. P
During infarction
DAVIT I (1984) [18] VERAPAMIL 1,436 6 MONTHS -9% >0.05
TRENT (1986) [96] NIFEDIPINE 4,491 1 MONTH +7% <0.56
SPRINT II (1993) [29] NIFEDIPINE 1,358 6 MONTHS +33% <0.09
After infarction
SPRINT I (1988) [48] NIFEDIPINE 2,276 10 MONTHS +7% 0.42
MDPIT (1988) [65] DILTIAZEM 2,466 25 MONTHS +2% >0.05
DAVIT II (1990) [19] VERAPAMIL 1,775 16 MONTHS -20% 0.11
CRIS (1996) [78] VERAPAMIL 1,083 2 YEARS +6% >0.05
 
META-ANALYSES No. STUDIES No. PATIENTS   VAR. P
During and after infarction
YUSUF (1988) [100] 3 dur., 4 after 6,000 dur,
9,000 after		   +10% dur,
+6% after		 NS
LAU (1992) [54] 16 dur., 6 after 6,420 dur,
13,114 after		   +12% dur
+1% after		 NS
TEO (1993) [93] 24 20,342   +4% 0.41

 

ACC/AHA GUIDELINES

  • Not recommended
  • (if ß-blockers are contraindicated o not tolerated, verapamil and diltiazem can used if left ventricular function is preserved)

ANMCO-SIC CLINICAL GUIDELINES

  • dihydropyridines contraindicated (type a)
  • verapamil and diltiazem can be used if ß-blockers contraindicated and EF>40%