Calcium-channel blockers in postmyocardial infarction patients with special notation to the Danish verapamil infarction trial II

Review of postinfarct treatment with verapamil: combined experience of early and late intervention studies with verapamil in patients with acute myocardial infarction. Danish Study Group on Verapamil in Myocardial Infarction

An overview of the published studies on the use of verapamil during and after an acute myocardial infarction is presented. Meta-analyses of the two small early intervention trials, one early intervention trial followed by a 6-month treatment period (The Danish Verapamil Infarction Trial I, DAVIT I) and one late intervention trial (DAVIT II), demonstrated a 17-20% statistically nonsignificant reduction of mortality, first reinfarctions, and first major events. In DAVIT II was found a statistically significant 20% reduction of first major events in verapamil-treated patients. In patients without heart failure during the acute event mortality, first reinfarctions and first major events were significantly reduced by 30-36% in verapamil-treated patients. No difference was found in patients treated for heart failure in the coronary care unit. A meta-analysis based on patients included in DAVIT I alive day 8 and all patients included in DAVIT II demonstrated a statistically significant 21-26% reduction of mortality, first reinfarctions, and first major events.