Vaage-Nilsen M, Hansen J F, Mellemgaard K, Hagerup L, Sigurd B, Steinmetz E
Department of Internal Medicine B, County Hospital of Hillerød, Denmark.
Int J Cardiol. 1995 Mar 3;48(3):255-8. doi: 10.1016/0167-5273(94)02258-k.
The Danish Verapamil Infarction Trial II (DAVIT II) demonstrated from the second postinfarction week, that long term treatment with verapamil significantly improved reinfarction free survival after an acute myocardial infarction (AMI). The present post hoc analysis of DAVIT II was undertaken with the purpose of evaluating the effect of treatment with verapamil in patients with early electrical complications, i.e. ventricular or atrial fibrillation, ventricular tachycardia, or second or third degree atrioventricular block, with or without mechanical complication, i.e. heart failure, during the first post-AMI week. In the placebo group, the 18-month mortality rate was lowest (9.5%) in patients without electrical or mechanical complications, highest (24.6%) in patients with electrical events only, and in-between (17.5%) in patients with mechanical problems regardless of presence of electrical complications. Verapamil significantly reduced the 18-month mortality rate in patients with early electrical without mechanical complications (60% reduction, P = 0.02), and in patients without mechanical complications (35% reduction, P = 0.02). Verapamil did not change the mortality rate in patients with mechanical complications.
丹麦维拉帕米梗死试验II（DAVIT II）表明，自心肌梗死后第二周起，维拉帕米长期治疗可显著改善急性心肌梗死（AMI）后的无再梗死生存率。对DAVIT II进行本次事后分析的目的是评估维拉帕米治疗对AMI后第一周内出现早期电并发症（即室性或房性颤动、室性心动过速或二度或三度房室传导阻滞）且伴有或不伴有机械并发症（即心力衰竭）的患者的疗效。在安慰剂组中，无电或机械并发症的患者18个月死亡率最低（9.5%），仅有电事件的患者最高（24.6%），有机械问题的患者（无论有无电并发症）死亡率介于两者之间（17.5%）。维拉帕米显著降低了有早期电并发症但无机械并发症患者的18个月死亡率（降低60%，P = 0.02），以及无机械并发症患者的18个月死亡率（降低35%，P = 0.02）。维拉帕米未改变有机械并发症患者的死亡率。
