[Anti-ischemic therapy with verapamil. Improving prognosis by secondary prevention after acute myocardial infarct]

Calcium antagonists reduce myocardial oxygen demand and increase the oxygen supply to the myocardium via a coronary dilating effect. For the treatment of silent myocardial ischämia and of stable and instable angina pectoris, studies with verapamil revealed an anti-ischemic efficacy comparable with that of beta blockers and nitrates. Studies of secondary prophylaxis after acute myocardial infarction reveal a cardioprotective effect of verapamil in terms of a reduction in mortality and re-infarction rates. Calcium antagonists have further organ-protective effects such as a reduction of left ventricular wall hypertrophy and a slowing effect on the progression of arteriosclerotic vascular changes.