Related Experiment Video

Updated: Jun 24, 2026

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
11:30

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro

Published on: June 2, 2022

Long-acting calcium antagonists in patients with coronary artery disease: a meta-analysis

Sripal Bangalore1, Sanobar Parkar, Franz H Messerli

  • 1Department of Medicine, Division of Cardiology, St. Luke's Roosevelt Hospital and Columbia University College of Physicians and Surgeons, New York, NY 10019, USA.

The American Journal of Medicine
|April 1, 2009
PubMed

Insights

Long-acting calcium channel blockers (CCBs) do not increase mortality in coronary artery disease patients. These CCBs reduce the risk of stroke, angina, and heart failure.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Coronary artery disease (CAD) treatment with calcium channel blockers (CCBs) is controversial due to potential risks.
  • Short-acting CCBs have adverse hemodynamic effects, but the role of long-acting CCBs in CAD is unclear.

Purpose of the Study:

  • To evaluate the efficacy and safety of long-acting CCBs in patients with coronary artery disease.
  • To assess the impact of long-acting CCBs on mortality and major cardiovascular events.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) from 1966 to August 2008.
  • Included studies involved long-acting CCBs in CAD patients with at least 1-year follow-up.
  • Extracted data on all-cause mortality, cardiovascular mortality, nonfatal myocardial infarction, stroke, angina, and heart failure.

Main Results:

  • 15 RCTs with 47,694 patients met the inclusion criteria.
  • Long-acting CCBs showed no increased risk for all-cause mortality, cardiovascular mortality, nonfatal myocardial infarction, or heart failure compared to control groups.
  • Significant reductions were observed in stroke (21%) and angina pectoris (18%), and heart failure (28%) compared to placebo.

Conclusions:

  • Long-acting CCBs, including dihydropyridines and nondihydropyridines, are safe for patients with coronary artery disease.
  • These agents are associated with reduced risks of stroke, angina pectoris, and heart failure.
  • Outcomes for other cardiovascular events were comparable to control groups.
Abstract

Related Concept Videos

Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
Antihypertensive Drugs: Action of Calcium Channel Blockers01:18

Antihypertensive Drugs: Action of Calcium Channel Blockers

Calcium ions are essential to contract smooth muscle cells in blood vessels. They enter these cells through voltage-dependent calcium channels, specifically L-type calcium channels in the cell membrane. These L-type calcium channels are integral to the excitation-contraction coupling process in smooth muscle. When a stimulus is received by smooth muscle cells, their membrane depolarizes. This alteration in membrane potential instigates the opening of L-type calcium channels. As a result,...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...