Efficacy of Calcium Channel Blocker in the Secondary Prevention of Myocardial Infarction Retrospective Analysis of the 10-Year Prognosis of Coronary Thrombolysis-Treated Patients

Shigemasa Tani; Ikuyoshi Watanabe; Ken Nagao; Kimio Kikushima; Kazuhiro Watanabe; Takeo Anazawa; Hirofumi Kawamata; Eizo Tachibana; Shingo Furuya; Toshifumi Sasanuma; Toshio Kushiro; Katsuo Kanmatsuse

doi:10.1253/circj.68.853

Clinical Investigation

Efficacy of Calcium Channel Blocker in the Secondary Prevention of Myocardial Infarction

Retrospective Analysis of the 10-Year Prognosis of Coronary Thrombolysis-Treated Patients

Shigemasa Tani, Ikuyoshi Watanabe, Ken Nagao, Kimio Kikushima, Kazuhiro Watanabe, Takeo Anazawa, Hirofumi Kawamata, Eizo Tachibana, Shingo Furuya, Toshifumi Sasanuma, Toshio Kushiro, Katsuo Kanmatsuse

Author information

Shigemasa Tani
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Ikuyoshi Watanabe
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Ken Nagao
Department of Emergency and Critical Care Medicine, Nihon University School of Medicine
Kimio Kikushima
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Kazuhiro Watanabe
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Takeo Anazawa
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Hirofumi Kawamata
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Eizo Tachibana
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Shingo Furuya
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Toshifumi Sasanuma
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Toshio Kushiro
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital
Katsuo Kanmatsuse
Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine and Surugadai Nihon University Hospital

Keywords: Calcium channel blocker, Long-term prognosis, Myocardial infarction (MI), Nifedipine-retard, Secondary prevention

JOURNAL FREE ACCESS

2004 Volume 68 Issue 9 Pages 853-859

DOI https://doi.org/10.1253/circj.68.853

Details

Abstract

Background Calcium channel blockers (CCBs) may have a positive influence on the long-term prognosis of Japanese patients with ischemic heart disease. Methods and Results The effect of nifedipine-retard (NR) (n=202) compared with that of non-CCB treatment (n=92) on the secondary prevention of myocardial infarction (MI) was retrospectively investigated in patients who had survived acute MI between 1987 and 1996. The primary endpoint was the occurrence of cardiac death or non-fatal MI. The median follow-up was 6.3±2.4 years. The incidence of cardiac events was 8.9% in the NR group and 14.1% in the non-CCBs group (p=0.14, odds ratio (OR): 0.584, 95% confidence interval (CI): 0.286-1,193). However, subanalysis revealed that NR significantly reduced the incidence of cardiac events in patients aged less than 55 years (4.2 vs 18.2%, p=0.016, OR: 0.180, 95%CI: 0.045-0.721) and those who did not smoke (8.6 vs 16.4%, p=0.048, OR: 0.462, 95%CI: 0.203-0.999). Conclusion Although this was a retrospective analysis, it showed that NR did not cause an increase in the incidence of cardiac events in post-MI patients; it even prevented cardiac events, especially in those who were less than 55 years of age and in non-smokers, suggesting the potential usefulness of CCBs in the secondary prevention of MI in Japan. (Circ J 2004; 68: 853 - 859)

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