Braun S, Boyko V, Behar S, Reicher-Reiss H, Shotan A, Schlesinger Z, Rosenfeld T, Palant A, Friedensohn A, Laniado S, Goldbourt U
Department of Cardiology, Tel Aviv Medical Center, Israel.
J Am Coll Cardiol. 1996 Jul;28(1):7-11. doi: 10.1016/0735-1097(96)00109-x.
This study sought to establish the risk ratio for mortality associated with calcium antagonists in a large population of patients with chronic coronary artery disease.
Recent reports have suggested that the use of short-acting nifedipine may cause an increase in overall mortality in patients with coronary artery disease and that a similar effect may be produced by other calcium antagonists, in particular those of the dihydropyridine type.
Mortality data were obtained for 11,575 patients screened for the Bezafibrate Infarction Prevention study (5,843 with and 5,732 without calcium antagonists) after a mean follow-up period of 3.2 years.
There were 495 deaths (8.5%) in the calcium antagonist group compared with 410 in the control group (7.2%). The age-adjusted risk ratio for mortality was 1.08 (95% confidence interval [CI] 0.95 to 1.24). After adjustment for the differences between the groups in age and gender and the prevalence of previous myocardial infarction, angina pectoris, hypertension, New York Heart Association functional class, peripheral vascular disease, chronic obstructive pulmonary disease, diabetes and current smoking, the adjusted risk ratio declined to 0.97 (95% CI 0.84 to 1.11). After further adjustment for concomitant medication, the risk ratio was estimated at 0.94 (95% CI 0.82 to 1.08).
The current analysis does not support the claim that calcium antagonist therapy in patients with chronic coronary artery disease, whether myocardial infarction survivors or others harbors an increased risk of mortality.
本研究旨在确定在大量慢性冠状动脉疾病患者中，与钙拮抗剂相关的死亡风险比。
最近的报告表明，使用短效硝苯地平可能会导致冠状动脉疾病患者的总体死亡率增加，其他钙拮抗剂，特别是二氢吡啶类钙拮抗剂，可能也会产生类似的效果。
在平均3.2年的随访期后，获得了11575名参加苯扎贝特预防心肌梗死研究筛查患者的死亡率数据（5843名使用钙拮抗剂，5732名未使用钙拮抗剂）。
钙拮抗剂组有495例死亡（8.5%），而对照组有410例死亡（7.2%）。年龄调整后的死亡风险比为1.08（95%置信区间[CI]0.95至1.24）。在对两组在年龄、性别以及既往心肌梗死、心绞痛、高血压、纽约心脏协会心功能分级、外周血管疾病、慢性阻塞性肺疾病、糖尿病和当前吸烟患病率方面的差异进行调整后，调整后的风险比降至0.97（95%CI 0.84至1.11）。在对合并用药进行进一步调整后，风险比估计为0.94（95%CI 0.82至1.08）。
目前的分析不支持以下观点，即慢性冠状动脉疾病患者，无论是否为心肌梗死幸存者，接受钙拮抗剂治疗会增加死亡风险。
