Impact of long-acting calcium channel blockers on the prognosis of patients with coronary artery disease with and without chronic kidney disease: a comparison of three drugs.
Calcium channel blockers (CCBs) can prevent cardiovascular events in patients with coronary artery disease (CAD). This study looked retrospectively at the prognosis of CAD in hypertensive patients with CAD who had undergone a coronary angiograph, had been given a CCB (benidipine [n = 66], amlodipine [n = 45], or long-acting nifedipine [n = 31]) on hospital discharge and were then followed up for a mean +/- SD of 5.2 +/- 2.9 years. Systolic/diastolic blood pressure for all 142 patients decreased significantly from a mean +/- SD of 137 +/- 20/74 +/- 15 mmHg to 129 +/- 20/71 +/- 12 mmHg. Major adverse cardiovascular events (MACE) occurred in 15 patients. Chronic kidney disease (CKD) was a significant risk factor for MACE (hazard ratio 2.35, 95% confidence intervals 1.45, 3.80). Benidipine was superior to nifedipine in preventing MACE in patients both with and without CKD. In conclusion, benidipine and amlodipine reduced the frequency of MACE in hypertensive patients with CAD, particularly in those with complicating CKD.
Division of Cardiology, Toyama Red Cross Hospital, Toyama, Japan. nitta@toyama-med.jrc.or.jp
Y
Y
Nitta
R
R
Yamamoto
Y
Y
Yamaguchi
S
S
Katsuda
B
B
Kaku
T
T
Taguchi
S
S
Takabatake
K
K
Nakahama
M
M
Yamagishi
D000368:Aged; D017311:Amlodipine / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000209:etiology*; D004095:Dihydropyridines / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D009543:Nifedipine / Q000494:pharmacology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D017311:Amlodipine; C061004:benidipine; D009543:Nifedipine