Document Detail


Calcium antagonists for secondary prevention of myocardial infarction: is there a need to shift from short-acting to long-acting types?
MedLine Citation:
PMID:  16247203     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Takaaki Taniwa; Masaru Miyataka; Akio Kimura; Mitsugu Taniguchi; Yutaka Hirano; Takahiro Hayashi; Kinji Ishikawa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2005-10-25     Completed Date:  2006-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1308-14     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Sakai Municipal Hospital, Japan.
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MeSH Terms
Descriptor/Qualifier:
Amlodipine / 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:
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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