Prognostic effects of calcium channel blockers on cardiac events, stroke and end-stage renal disease in patients with angina pectoris. Retrospective comparative study of benidipine, diltiazem and nifedipine.
OBJECTIVE
Calcium channel blockers (CCBs) have been reported to reduce the incidence of stroke in hypertensive patients. CCBs are also commonly used to treat patients with angina pectoris (AP). However, there are very few reports on their effects on cardiovascular events, including stroke and end-stage renal disease (ESRD), in patients with AP. This study was designed to assess the differences among CCBs regarding the occurrence of cardiovascular events in patients with AP.


METHODS
Clinical records of 226 patients with AP who had received treatment with CCBs in hospital from January 1, 1993 to December 31, 2006 were reviwed. The influence of patient characteristics and medication on the occurrence of cardiovascular events was evaluated (median follow-up period: 4.4 years). Of these 226 patients, 155 were treated with benldipine (CAS 91599-74-5), 36 with diltiazem (CAS 33286-22-5), and 35 were treated with nifedipine (CAS 21629-25-4).


RESULTS
Cox proportional hazard regression analysis showed that benidipine was the only CCB that significantly reduced the occurrence of cardiovascular events (HR = 0.39, p < 0.05). Benidipine treatment was associated with higher cardiovascular- and cardiac event-free rates than diltiazem treatment, and higher stroke- and ESRD-free rates than nifedipine.


CONCLUSIONS
This study demonstrated that benidipine prevents the occurrence of cardiovascular events in patients with AP, suggesting that benidipine contributes to a favorable long-term prognosis of such patients.
Arioka
Ichiro
I
Division of Cardiovascular Surgery, Dohi Hospital, Hiroshima, Mihara, Japan. ichiro13@kitamiyake.jp
Dohi
Shunichiro
S
Dohi
Shizuyuki
S
Sakai
Kenya
K
D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000188:drug therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000627:therapeutic use; D004110:Diltiazem / Q000627:therapeutic use; D005260:Female; D006331:Heart Diseases / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D009543:Nifedipine / Q000627:therapeutic use; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D002121:Calcium Channel Blockers; D004095:Dihydropyridines; C061004:benidipine; D004110:Diltiazem; D009543:Nifedipine