Angina after aortocoronary bypass grafting: combined medical therapy including nifedipine.

A second coronary artery revascularization procedure often yields poor results. Nifedipine, a calcium antagonist, was added to the current medical therapy consisting of maximal doses of beta blockers and nitrates in a group of 18 patients who had had one revascularization procedure and subsequently had class 3 and 4 angina pectoris. The overall favorable clinical response was 72%. The average dose of nifedipine to achieve a clinical response was 90 mg/day. Left ventricular function improved with time. We believe nifedipine is an important adjunct in the management of angina after coronary bypass operation.