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European Heart Journal 1994 15(2):270-276;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

The prognostic significance of post-infarction angina pectoris and the effect of verapamil on the incidence of angina pectoris and prognosis

C. M. JESPERSEN, J. FISCHER HANSEN, L. SPANGE MORTENSEN and THE DANISH STUDY GROUP ON VERAPAMIL IN MYOCARDIAL INFARCTION

The Danish Study Group on Verapamil in Myocardial infarction, Copenhagen, Denmark

Received 2 September 1992; revised 8 April 1993; .

Coresspondence: C M. Jespersen, Department of Cardiology. Hvidore Hospital, Kcttegàrdsalle 33. DK 2650 Hvidovre. Denmark

Abstract

The prognostic sign of angina pectoris and the effect of intervention with verapamil on the incidence of angina pectoris were studied in patients recovering from myocardial infarction and included in the Danish Verapamil Infarction Trial II. During the second week after admission patients were double-blindly randomized to treatment with verapamil 360 mg. day–1 or placebo. Treatment was continued for up to 18 months. At discharge angina pectoris was reported in 11% of 869 patients randomized to verapamil and in 12% of 888 randomized to placebo (ns). One month after discharge a significantly increase in the prevalance of angina pectoris was reported in both the verapamil (33%) (P<0·001) and the placebo groups (39%) (P <0·001). The one month prevalence of angina pectoris (P=0·03) and the 18 months overall incidence of angina pectoris (P= 0·002) were both .sigificant lower in the verapamil group compared with placebo. Stable angina pectoris during the first month of follow-up was a significant predictor of major events (i.e. death or reinfarction) (hazard ratio = 1·45; 95% confidence limits: 1·10 1·89). As verapamil significantly reduced the incidence of angina pectoris during daily activities, and thereby the number of patients at high risk, the beneficial effect of verapamil in reducing major events in patients recovering from myocardial infarction is likely to be due to abolishing myocardial ischaemia.

Key Words: Myocardial infarction • angina pectoris • prognosis • verapamil


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