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European Heart Journal 1995 16(Supplement H):13-17; doi:10.1093/eurheartj/16.suppl_H.13
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Anti-ischaemic intervention with verapamil in patients recovering from acute myocardial infarction

C. M. Jespersen

Department of Cardiology, University of Copenhagen Hvidovre, Denmark

Correspondence: C. M. Jespersen, University of Copenhagen, Department of Cardiology 146, Hvidovre Hospital, Kettegaard Alle 30, DK.2650, Hvidovre, Denmark

The present review discusses the prognostic significance of post-infarction angina pectoris, and the significance of post-infarction intervention with verapamil on the prevalence of post-infarction ischaemia and prognosis.

Angina pectoris during the first month after acute myocardial infarction (AMI) was found to be a significant predictor of subsequent major events (death and reinfarction) (P = 0·03). The prognosis in patients with post-infarction angina pectoris was as poor as that observed in patients with mild to moderate congestive heart failure.

Intervention with verapamil significantly reduced the 1 month prevalence of angina pectoris (P = 0·02), and thereby also the number of patients at high risk. In patients with ST-segment depression provoked during a pre-discharge, post- infarction exercise test, intervention with verapamil reduced major events by 41 % compared with placebo. In patients with both heart failure and angina pectoris, anti-ischaemic intervention with verapamil reduced the 17 month event rate by 37%, whereas no effect was found in patients with heart failure, but no angina pectoris.

We conclude that angina pectoris following AMI is a sign risk predictor in both patients with and without impaired cardiac function. Intervention with verapamil sign ficantly reduces post-infarction ischaemia, thereby reducing the risk of reinfarction and death.

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


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