Related Experiment Video

Updated: May 14, 2026

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration
07:59

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

Published on: April 4, 2022

Calcium antagonists in the treatment of coronary artery disease

Rhonda M Cooper-DeHoff1, Shin-Wen Chang, Carl J Pepine

  • 1Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, PO Box 100486, 1600 SW Archer Road, Gainesville, FL 32610-0486, USA.

Current Opinion in Pharmacology
|February 14, 2013
PubMed

Insights

Long-acting calcium antagonists (CAs) are safe and effective for treating coronary artery disease (CAD). These drugs offer cardiovascular benefits or equivalence, making them a potential first-line option for managing CAD.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Calcium antagonists (CAs) use in coronary artery disease (CAD) was historically limited by adverse events from short-acting formulations.
  • Recent evidence challenges these limitations, prompting a re-evaluation of CA efficacy and safety.

Purpose of the Study:

  • To evaluate the current role and safety of calcium antagonists in managing coronary artery disease.
  • To assess the cardiovascular outcomes associated with long-acting CA formulations.

Main Methods:

  • Review of large-scale randomized clinical trials and meta-analyses on calcium antagonist use in CAD.
  • Analysis of cardiovascular outcomes comparing long-acting CAs with other therapeutic agents.

Main Results:

  • Long-acting CAs demonstrate safety and efficacy in patients with or at risk for CAD.
  • These agents show benefit or equivalence in cardiovascular outcomes compared to other treatments.
  • CAs are metabolically neutral and well-tolerated, with pleiotropic effects beneficial for risk management.

Conclusions:

  • Long-acting calcium antagonists are a safe and effective treatment option for coronary artery disease.
  • Their favorable profile supports consideration as a first-line therapy for CAD management.
  • CAs can be used alone or in combination with other agents for comprehensive cardiovascular risk reduction.

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...
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...
Antianginal Drugs: Nitrates and β-Blockers01:16

Antianginal Drugs: Nitrates and β-Blockers

In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates,  such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...