Secondary preventive effects of a calcium antagonist for ischemic heart attack: randomized parallel comparison with
Akihiro Nakagomi1, Eitaro Kodani, Hitoshi Takano
1Department of Internal Medicine and Cardiology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo, Japan. nakagomi@nms.ac.jp
Insights
Calcium channel antagonists (CCAs) are as effective as beta-blockers (BBs) in preventing cardiovascular events in post-myocardial infarction (MI) patients. This study compared BBs and CCAs, finding similar efficacy and tolerability for both treatments in post-MI care.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Beta-blockers (BBs) are recommended for hypertension and acute myocardial infarction (AMI).
- Calcium channel antagonists (CCAs) treat hypertension and angina.
- CCA efficacy in preventing cardiovascular events post-myocardial infarction (MI) compared to BBs is unclear.
Purpose of the Study:
- To compare the efficacy of CCAs versus BBs in preventing cardiovascular events in post-MI patients.
- To evaluate the safety and tolerability of CCAs and BBs in this patient population.
Main Methods:
- 120 post-MI patients were randomized to receive either BB (atenolol) or CCA (benidipine).
- Patients with recent AMI or vasospastic angina were excluded.
- Primary composite outcome and adverse events were monitored.
Main Results:
- The primary composite outcome rate was 26.3% in the BB group versus 13.3% in the CCA group (Hazard Ratio 0.640, P=0.276).
- No significant difference in cardiovascular event rates was observed between the groups.
- Both BB and CCA treatments were well-tolerated with few severe adverse events.
Conclusions:
- CCA treatment demonstrates comparable effectiveness to BBs in reducing cardiovascular events in post-MI patients.
- CCAs represent a viable alternative to BBs for cardiovascular event prevention in post-MI individuals.
- Further research may explore long-term outcomes and specific patient subgroups.
Background:
Beta-blockers (BB) have been widely used in the management of hypertension and acute myocardial infarction (AMI), and both national and international guidelines have recommended them as first-line agents. Calcium channel antagonists (CCA) are also effective in the treatment of hypertension and angina pectoris. However, the efficacy of CCA in the prevention of cardiovascular events in post-myocardial infarction (MI) patients in comparison to that of BB remains unclear.
Methods And Results:
A total of 120 post-MI patients (71 patients who were at least 1 month after the onset AMI and 49 stable coronary artery disease patients with a history of MI) were randomly assigned to receive a BB (atenolol, 25-50mg/day, n=60) or a CCA (benidipine, 4-8 mg/day, n=60). All patients with AMI within the previous 1 month or with vasospastic angina were excluded from the present study. The baseline clinical characteristics were generally similar in the BB and CCA groups. The rate of primary composite outcome was 26.3% in the BB group in comparison to 13.3% in the CCA group, with no significant between-group differences (hazard ratio with the CCA group 0.640, P=0.276). Both treatments were well tolerated with few severe adverse events.
Conclusions:
CCA treatment was found to be as effective as BB in reducing cardiovascular events in post-MI patients.
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