Calcium antagonists in secondary prevention after myocardial infarction

A reliable theoretical background exists to support a secondary preventive effect of calcium antagonists after myocardial infarction. Recent studies also indicate that positive results can be achieved with diltiazem and, in particular, verapamil, provided that they are not given to patients suffering clinically manifest myocardial failure during the acute phase of the disease. When the results of treatment with verapamil and diltiazem are compared with comparable studies with beta-blockers, there is no convincing difference as to their effect on a reduction in mortality. However, studies on nifedipine have shown a negative trend, indicating that the calcium channel blockers should not be regarded as one entity in this respect.