Do calcium inhibitors have any role in secondary prevention of myocardial infarction?]

The value of using calcium blockers in post-infarction secondary prevention is controversial. The HELD meta-analysis (1989) involving 17,759 patients concluded that they made no contribution in this indication (9.8% mortality rate vs 9.3% in the control group). The findings of the DAVIT II study with verapamil demonstrate a significant reduction in the infarction recurrence rate (18% vs 21.6%) in the treatment group. In the patients without heart failure, there was some benefit in terms of reduced mortality (7.7% vs 11.8%). The true contribution of calcium channel inhibitors, relative to that of beta-blockers in post-infarction medication should be analyzed in function of the various infarction sub-groups (no Q-wave, thrombolytic, with or without left ventricular dysfunction), of the calcium channel inhibitor being investigated and of the administration regimen.