Temporal pattern of the effect of verapamil on myocardial reinfarction. DAVIT Study Group. Danish Verapamil Infarction Trial
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Updated: Oct 22, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
A Sajadieh1, J F Hansen, L S Mortensen
1Department of Cardiovascular Medicine, Copenhagen University Hospital of Bispebjerg, Denmark.
Insights
Verapamil significantly reduced early reinfarction rates after a heart attack. However, verapamil did not show a significant effect on late reinfarction in patients following an initial myocardial infarction.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Myocardial infarction (MI) poses a significant risk for subsequent reinfarction.
- Understanding the temporal effects of medications on reinfarction is crucial for patient management.
Purpose of the Study:
- To compare the efficacy of verapamil in preventing early versus late reinfarction after an initial MI.
Main Methods:
- A secondary analysis of the Danish Verapamil Infarction Trial II involving 1775 patients (<76 years) with acute MI.
- Patients were followed for 18 months, with reinfarctions categorized as early (first 5 months) or late (last 13 months).
- Cox regression analysis was used to evaluate the impact of verapamil versus placebo on reinfarction rates.
Main Results:
- Verapamil significantly reduced total reinfarction and early reinfarction rates on univariate analysis.
- Multivariate analysis confirmed that verapamil specifically reduced the rate of early reinfarction (HR 0.59; 95% CI 0.39-0.90).
- No significant effect of verapamil was observed on late reinfarction rates in either univariate or multivariate analyses.
Conclusions:
- Verapamil demonstrates a beneficial effect in reducing early reinfarction following an index myocardial infarction.
- The drug's efficacy appears limited to the early post-MI period, with no significant impact on late reinfarction rates.
- Predictors for early and late reinfarction differ, suggesting distinct pathophysiological mechanisms influencing reinfarction timing.
Abstract:
The purpose of this study was to compare the effects of verapamil on early versus late reinfarction after an index myocardial infarction. A total of 1775 consecutive patients < 76 years of age, with acute myocardial infarction, included in the Danish Verapamil Infarction Trial II, were followed for 18 months. Reinfarctions during the observation period were retrospectively divided into the 50% earliest occurring and the 50% latest occurring (early and late reinfarction, respectively). Cox regression analysis was applied to assess the significance of clinical baseline variables and treatment group (verapamil vs. placebo) on early, late, and total reinfarction. One hundred and ninety-one reinfarctions were registered during the 18-month observation: 96 in the first 5 months (early) and 95 in the last 13 months (late). On univariate analysis verapamil significantly reduced the rate of total reinfarction (P = 0.04, hazard ratio [HR] = 0.77; 95% confidence Interval [CI] 0.58-1.03) and early reinfarction (P = 0.007, HR 0.56; 95% CI 0.37-0.86), but not late reinfarction (P = 0.99, HR = 1.05; 95% CI 0.70-1.56). In a multivariate model, only the rate of early reinfarction was reduced by verapamil (P = 0.012, HR = 0.59, 95% CI 0.39-0.90). Additionally, predictors of early and late reinfarction were quite different in this model. After an index myocardial infarction verapamil reduces the rate of early but not late reinfarction.
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