Influence of calcium antagonists on long-term survival of patients treated with coronary angioplasty

Hideaki Kanzaki, Shunichi Miyazaki, Teruo Noguchi, Satoshi Yasuda, Hitoshi Sumida, Satoshi Daikoku, Isao Morii, Akira Itoh, Yoichi Goto, Hiroshi Nonogi

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

A meta-analysis reported that nifedipine increased mortality dose-dependently in patients with coronary artery disease. However, there have been few studies (specifically in Asians) on the long-term prognosis of patients treated with calcium antagonists after successful coronary angioplasty (PTCA). The subjects consisted of 583 consecutive patients (461 males, aged 59 ± 10), who underwent successful elective PTCA between 1985 and 1990. First, they were divided into two groups; the calcium antagonist (+) group (n = 560) and the calcium antagonist (-) group (n = 23), and were evaluated in terms of total survival and cardiac events. Second, the calcium antagonist (+) group was further divided into 4 groups according to calcium antagonist type, i.e., short-acting nifedipine group (n = 156), long-acting nifedipine group (n = 203), diltiazem group (n = 184) and the other group (n = 17), and these groups were evaluated in the same way. The primary end-point was set as death from any cause. Secondary end-points were any cardiac events, including non-fatal acute myocardial infarction, coronary artery bypass surgery and repeat PTCA. The mean follow-up period was 4.5 ± 1.8 years. A multivariate analysis was performed with the Cox proportional-hazard model. The Kaplan-Meier analysis showed that the calcium antagonist (-) group had significantly worse prognoses than the calcium antagonist (+) group (p < 0.05), and that there was no significant difference among the prognoses of the four calcium antagonists groups. The multivariate analysis revealed that the use of a calcium antagonist was one of the independent factors positively contributing to the prognosis. The use of any type of calcium antagonist did not increase mortality in patients who underwent successful elective PTCA, rather, it contributed to a favorable outcome.

Original languageEnglish
Pages (from-to)11-21
Number of pages11
JournalJapanese Heart Journal
Volume40
Issue number1
DOIs
Publication statusPublished - 1999 Jan
Externally publishedYes

Keywords

  • Coronary angioplasty
  • Long-term prognosis
  • Nifedipine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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