REVIEW OF POSTINFARCT TREATMENT WITH VERAPAMIL

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 VerapamiI 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 DBVIT 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 DBVIT 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.