A meta-analysis of randomized trials of calcium antagonists to reduce restenosis after coronary angioplasty.
The usefulness of calcium antagonists to reduce restenosis after coronary angioplasty remains uncertain despite 5 randomized trials involving 919 patients. Review and meta-analysis of these trials are performed to provide insight into whether calcium antagonists reduce angiographic restenosis. In aggregate, these trials suggest that patients treated with calcium antagonists had approximately a 30% reduction in the odds of angiographic restenosis (odds ratio = 0.68; 95% confidence interval of 0.49 to 0.94, p = 0.03) compared with control patients. Given the relatively low toxicity and cost of these agents, this reduction in angiographic restenosis may translate into a meaningful clinical benefit. A large, randomized clinical trial should be performed to confirm these findings before widespread adoption of this treatment strategy.
Hillegass
W B
WB
Interventional Cardiac Catheterization Laboratory, Duke University Medical Center, Durham, North Carolina 27710.
Ohman
E M
EM
Leimberger
J D
JD
Califf
R M
RM
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000628:therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence
D002121:Calcium Channel Blockers