Update on the use of angiotensin converting enzyme inhibitors and calcium antagonists in postinfarction patients.

AIM

To review the results of recent studies on the use of angiotensin converting enzyme (ACE) inhibitors and calcium antagonists in patients after an acute myocardial infarction.

METHOD

Literature review.

CONCLUSIONS

ACE inhibition reduces mortality and morbidity and improves quality of life in a cost-effective way, demonstrating increased benefits with increasing risks. Calcium antagonism with verapamil and possibly diltiazem reduces mortality and morbidity, except in patients with congestive heart failure without signs of reversible myocardial ischaemia. Nifedipine may have negative effects. The efficacy of the second-generation dihydropyridines remains to be demonstrated.