Storstein L
Eur Heart J. 1986 Jul;7 Suppl B:59-62. doi: 10.1093/eurheartj/7.suppl_b.59.
Experimental studies have shown that calcium antagonists are beneficial in reducing myocardial damage following induced infarction and thus substantiate the concept that these drugs may influence reinfarction rate and death following myocardial infarction in man. Multicenter studies with verapamil and nifedipine are in progress but without conclusive results as yet. Which patients--if any--should receive calcium antagonists for secondary prevention after myocardial infarction remains an open question. The answer will depend on whether calcium antagonists are greater, equal or less effective than beta blockers for this purpose. If calcium antagonists should prove more efficacious than beta blockers, it would seem reasonable to give calcium antagonists preference for secondary prevention in those patients where contraindications to these drugs do not exist. If however, beta blockers prove the better alternative, they should be given preference unless beta blockers are contraindicated. The complex question of the future role of drugs in secondary prevention after myocardial infarction is by far not clarified and socioeconomic consequences as well as quality of life will have to be considered in context with drug influence on survival.
实验研究表明，钙拮抗剂有助于减少诱导性心肌梗死后的心肌损伤，从而证实了这些药物可能会影响人类心肌梗死后的再梗死率和死亡率这一概念。关于维拉帕米和硝苯地平的多中心研究正在进行中，但尚未得出确凿结果。心肌梗死后哪些患者（如果有的话）应该接受钙拮抗剂进行二级预防仍然是一个悬而未决的问题。答案将取决于钙拮抗剂在这方面是否比β受体阻滞剂更有效、效果相当还是效果更差。如果钙拮抗剂被证明比β受体阻滞剂更有效，那么在那些不存在这些药物禁忌症的患者中，优先给予钙拮抗剂进行二级预防似乎是合理的。然而，如果β受体阻滞剂被证明是更好的选择，那么除非有禁忌症，否则应该优先使用β受体阻滞剂。药物在心肌梗死后二级预防中的未来作用这一复杂问题目前远未明确，并且在考虑药物对生存的影响时，必须结合社会经济后果以及生活质量进行考量。
