Secondary prevention of death and reinfarction with verapamil after an acute myocardial infarction. The Danish Study Group on Verapamil in Myocardial Infarction.

The effect of verapamil on death, reinfarctions, and major events i.e. reinfarction or death, has been investigated in two Danish double-blind, placebo-controlled verapamil infarction trials DAVIT I and II. DAVIT I, which was an early intervention trial, demonstrated that after six months there was a statistically non-significant reduction of mortality and reinfarction. DAVIT II demonstrated a non-significant reduction of mortality rate (P = 0.11, hazard ratio 0.80, 95% confidence limits 0.61-1.05), a significant reduction of reinfarction rate (P = 0.04, 0.77, 0.58-1.03), and major event rate (P = 0.03, 0.80, 0.64-0.99) in the verapamil group compared with the placebo group. Meta-analyses of DAVIT I (including only patients alive on day eight) and of DAVIT II showed a statistically significant reduction of odds ratio of mortality of 22% (P = 0.04), of reinfarctions of 27% (P = 0.02), and of major events of 21% (P = 0.02). It is concluded that long-term treatment with verapamil after an acute myocardial infarction is associated with a significant reduction in overall mortality, major events, and reinfarction rates.