title: Secondary prevention with verapamil after myocardial infarction. The Danish Study Group on Verapamil in Myocardial Infarction.
abstract: The effect of verapamil on death and major events (i.e., death or reinfarction) after an acute myocardial infarction was studied in a double-blind, randomized, placebo-controlled, multicenter trial, the Danish Verapamil Infarction Trial II (DAVIT II). Eight hundred seventy-eight patients started treatment with verapamil 360 mg/day and 897 patients with placebo. Treatment continued for up to 18 months (mean 16 months). Ninety-five deaths and 146 major events occurred in the verapamil group and 119 deaths and 180 major events in the placebo group. Eighteen-month mortality rates were 11.1 and 13.8% (hazard ratio 0.80, 95% confidence limits 0.63 to 1.05, p = 0.108), and major event rates 18.0 and 21.6% (0.80, 0.64 to 0.99, p = 0.027) in the verapamil and placebo groups respectively. When combining the results of this trial with the results of the first Danish study on verapamil in myocardial infarction, the meta-analysis demonstrated that treatment with verapamil from the second week after an acute myocardial infarction resulted in a reduction of pooled odds ratios of 0.22 (95% confidence interval 0.01 to 0.37, p = 0.04) for death, 0.21 (0.05 to 0.35, p = 0.02) for major events, and 0.27 (0.06 to 0.43, p = 0.02) for first reinfarctions. It is concluded that long-term treatment with verapamil after an acute myocardial infarction is associated with a significant reduction in overall mortality as well as major event and reinfarction rates.
mesh_terms: D002784:Cholesterol / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D012189:Retrospective Studies; D014700:Verapamil / Q000627:therapeutic use*
chemical_list: D002784:Cholesterol; D014700:Verapamil