[Evolution of myocardial ischemia therapy: calcium antagonists and ACE-inhibitors].

We have considered the possibility that the association between Ca(2+)-antagonists and ACE-inhibitors may be useful to treat patients with myocardial infarction. The two classes of drugs have synergic and complementary effects in terms of mechanism and site of action and of cardioprotective properties. In clinical trials Ca(2+)-antagonists failed to improve prognosis of patients with myocardial infarction, except verapamil which reduces mortality in patients with myocardial infarction and without pulmonary congestion. ACE-inhibitors are effective only in patients with myocardial infarction and congestive heart failure. Thus the two classes of drugs could be useful to treat patients with myocardial infarction but this hypothesis has to be confirmed with properly designed clinical trials.