Nifedipine in acute myocardial infarction

Preliminary experimental and clinical data suggest that nifedipine can abort early acute myocardial infarction (AMI) or decrease infarct size by reversal of coronary artery spasm, improved coronary flow to the ischemic zone, reduction in myocardial oxygen demand or protection of ischemic cells. The first large clinical trial testing the ability of nifedipine to reduce infarct size, the Nifedipine Angina Myocardial Infarction Study, was recently reported. Nifedipine treatment failed to prevent progression of threatened infarction to AMI or to reduce infarct size in patients with AMI. The study suggested an increased early mortality rate in patients with AMI treated with nifedipine, but this finding should be interpreted with caution pending the results of similar trials now in progress.