Efficacy of calcium channel blocker in the secondary prevention of myocardial infarction--retrospective analysis of the 10-year prognosis or coronary thrombolysis-treated patients.
BACKGROUND
Calcium channel blockers (CCBs) may have a positive influence on the long-term prognosis of Japanese patients with ischemic heart disease.


RESULTS
The effect of nifedipine-retard (NR) (n=202) compared with that of non-CCB treatment (n=92) on the secondary prevention of myocardial infarction (MI) was retrospectively investigated in patients who had survived acute MI between 1987 and 1996. The primary endpoint was the occurrence of cardiac death or non-fatal MI. The median follow-up was 6.3+/-2.4 years. The incidence of cardiac events was 8.9% in the NR group and 14.1% in the non-CCBs group (p=0.14, odds ratio (OR): 0.584, 95% confidence interval (CI): 0.286-1,193). However, subanalysis revealed that NR significantly reduced the incidence of cardiac events in patients aged less than 55 years (4.2 vs 18.2%, p=0.016, OR: 0.180, 95%CI: 0.045-0.721) and those who did not smoke (8.6 vs 16.4%, p=0.048, OR: 0.462, 95%CI: 0.203-0.999).


CONCLUSIONS
Although this was a retrospective analysis, it showed that NR did not cause an increase in the incidence of cardiac events in post-MI patients; it even prevented cardiac events, especially in those who were less than 55 years of age and in non-smokers, suggesting the potential usefulness of CCBs in the secondary prevention of MI in Japan.
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital, Chiyoda-ku, Tokyo, Japan. tanishigem@yahoo.co.jp
Shigemasa
S
Tani
Ikuyoshi
I
Watanabe
Ken
K
Nagao
Kimio
K
Kikushima
Kazuhiro
K
Watanabe
Takeo
T
Anazawa
Hirofumi
H
Kawamata
Eizo
E
Tachibana
Shingo
S
Furuya
Toshifumi
T
Sasanuma
Toshio
T
Kushiro
Katsuo
K
Kanmatsuse
D000368:Aged; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D003328:Coronary Thrombosis / Q000188:drug therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*; D015425:Myocardial Reperfusion; D009543:Nifedipine / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D013997:Time Factors
D002121:Calcium Channel Blockers; D005343:Fibrinolytic Agents; D009543:Nifedipine