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Prognostic effects of calcium channel blockers in patients with vasospastic angina--a meta-analysis

Kazuhiko Nishigaki1, Yukiko Inoue, Yoshio Yamanouchi

  • 1Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.

Circulation Journal : Official Journal of the Japanese Circulation Society
|July 30, 2010
PubMed

Insights

Benidipine offers better long-term outcomes for vasospastic angina (VSA) patients compared to other calcium channel blockers (CCB). This meta-analysis found benidipine significantly reduced major adverse cardiovascular events (MACE) in VSA patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Research

Background:

  • Calcium channel blockers (CCB) are effective for vasospastic angina (VSA) symptom control.
  • Prognostic benefits of CCB in VSA patients require further large-scale investigation.

Purpose of the Study:

  • To evaluate the prognostic effects of different CCB on major adverse cardiovascular events (MACE) in Japanese VSA patients.

Main Methods:

  • A meta-analysis of 4 studies involving 1,997 VSA patients with positive coronary spasm provocation tests.
  • Patients were treated with benidipine, amlodipine, nifedipine, or diltiazem.
  • Comparison of MACE occurrence rates and hazard ratios among the CCB groups.

Main Results:

  • A total of 143 MACE were recorded, including cardiac death, myocardial infarction, heart failure, and stroke.
  • Benidipine treatment was associated with a significantly lower hazard ratio for MACE compared to diltiazem.
  • This benefit persisted even after adjusting for patient characteristics.

Conclusions:

  • Benidipine demonstrates superior prognostic effects in reducing MACE among major CCB used for VSA.
  • The findings suggest benidipine as a potentially more beneficial treatment option for VSA patients.
Abstract

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