title: Mechanisms whereby calcium channel antagonists may protect patients with coronary artery disease.
abstract: Calcium antagonists have multiple mechanisms whereby they are able to protect against myocardial ischaemia. Recently questions have been posed about the long-term safety of this group of agents. This article is a selective rather than a complete review of the problems. Fears have largely centred around rapidly acting nifedipine when inappropriately used. This agent remains useful in Prinzmetal's angina, a condition in which there are no long-term comparative outcome studies. Current evidence is that verapamil is as safe and as effective as the beta-blocker in effort angina and that non-dihydropyridines (verapamil and diltiazem) are efficacious in the follow up of non-Q wave infarct. Verapamil post-infarct is safe and reduces reinfarction, provided that clinical heart failure is first excluded.
authors.affiliation: Ischaemic Heart Disease Research Unit, Medical Research Council, University of Cape Town Medical School, South Africa.
authors.forename: L H
authors.initials: LH
authors.lastname: Opie
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000494:pharmacology* / Q000627:therapeutic use; D003327:Coronary Disease / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D009200:Myocardial Contraction / Q000187:drug effects; D012449:Safety; D016896:Treatment Outcome; D014661:Vasoconstriction / Q000187:drug effects
chemical_list: D002121:Calcium Channel Blockers