[Calcium antagonists in the secondary prevention of myocardial infarction].

We performed a meta-analysis on data from trials of calcium antagonist drugs in the secondary prevention of myocardial infarction. Nifedipine (9,033 patients) increased total mortality non significantly by 12% at the end of follow-up, and by 62% (p = 0.02) before 21 days, with no significant change in the risk of reinfarction. Diltiazem or verapamil did not change total mortality significantly; each of them decreased the risk of reinfarction not significantly (p = 0.06) by approximately 20%. Treatment by either diltiazem or verapamil (8,356 patients) decreased the risk of reinfarction by 21% (p = 0.009). No benefit has been demonstrated with nifedipine in the secondary prevention of myocardial infarction. Verapamil or diltiazem may be an alternative to beta-blockers when these lasts drugs are contra-indicated, although one cannot reasonably expect from the first two drugs a decrease in mortality.