| Calcium antagonists for secondary prevention of myocardial infarction: is there a need to shift from short-acting to long-acting types? | |
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MedLine Citation:
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PMID: 16247203 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although short-acting nifedipine does not prevent myocardial infarction (MI), calcium antagonists with a long half-life may be effective. METHODS AND RESULTS: The present study was a retrospective analysis of the incidences of cardiac events among patients with a healed MI treated with 3 times-a-day type nifedipine (half-life 1.8 h; n=617), twice-a-day type nifedipine (half-life 4.0 h; n=527) and those not taking calcium antagonists (n=1,593) from 1986 to 1993, and the incidences of those on once-a-day type calcium antagonists (half-life 11.0 h; n=903) and those not taking calcium antagonists (n=2,788) from 1994 to 2001. Cardiac events included cardiac death and nonfatal recurrent MI. Single and multivariate analyses using the Cox-Hazard model were performed. From 1986 to 1993 cardiac events occurred in 38 patients with 3-times-a-day nifedipine (6.2%, hazard ratio and 95% confidence interval: 1.45 and 0.93-2.27), in 18 patients with twice-a-day nifedipine (3.4%: 0.68 and 0.39-1.20), 57 patients without calcium antagonists (3.6%). Cardiac events also occurred in 11 patients with once-a-day type nifedipine (1.2%: 0.72 and 0.37-1.42) and 48 patients without calcium antagonists (1.7%). Of the once-a-day type calcium antagonists, cardiac events were the lowest (2 patients, 0.6%: 0.32 and 0.08-1.31) in patients with amlodipine (half-life 39.0 h; n=334), which has the longest half-life. None of these drugs were a significant factor in the increase or decrease in the incidence of cardiac events. However, there was a good correlation between the half-life of the calcium antagonist and the hazard ratio for reducing cardiac events. CONCLUSION: Although there was a tendency toward a reduction in cardiac events using calcium antagonists with long half-life, none of these drugs could significantly reduce the incidence of cardiac events in patients with a healed MI. |
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Authors:
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Takaaki Taniwa; Masaru Miyataka; Akio Kimura; Mitsugu Taniguchi; Yutaka Hirano; Takahiro Hayashi; Kinji Ishikawa |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation journal : official journal of the Japanese Circulation Society Volume: 69 ISSN: 1346-9843 ISO Abbreviation: Circ. J. Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-10-25 Completed Date: 2006-03-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101137683 Medline TA: Circ J Country: Japan |
Other Details:
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Languages: eng Pagination: 1308-14 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular Medicine, Sakai Municipal Hospital, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amlodipine
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administration & dosage* Calcium / antagonists & inhibitors*, metabolism Calcium Channel Blockers / administration & dosage* Female Humans Male Middle Aged Myocardial Infarction / metabolism, mortality, prevention & control* Nifedipine / administration & dosage Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Calcium Channel Blockers; 21829-25-4/Nifedipine; 7440-70-2/Calcium; 88150-42-9/Amlodipine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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