Danish Study Group on Verapamil in MI - DAVIT II
Verapamil versus placebo after acute MI.
To evaluate the effect on total mortality and major cardiac events of verapamil started in the second week after MI.
Patients Screened: Not reported
Patients Enrolled: 1975
NYHA Class: At 12 month follow-up: Class I: 75.8%, Class II: 22.7%, Class III-IV: 1.5%
Mean Follow Up: average 16 months
Mean Patient Age: = 65 years: 34%
Mean Ejection Fraction: Not evaluated
<75 years of age enrolled 7–15 days after proven MI
SBP <90 mm Hg, second- or third-degree heart block at 3 days, heart failure not stabilizing on furosemide ≤160 mg/day, treatment with β-blockers or calcium antagonists due to angina pectoris, arrhythmias, hypertension, postoperative infarction, and significant valvular or congenital heart disease.
Death and reinfarction
Sudden death, cardiac death, and cardiac events (cardiac death or reinfarction)
Verapamil 120 mg three times daily (once or twice daily dosing allowed in cases of adverse drug reactions), or placebo.
The verapamil group had a 17% lower incidence of death and reinfarction (18.0% vs. 21. 6%; p = 0.03). There was also a nonsignificant 20% lower mortality (11.1% vs. 13.8%; p = 0.11) with a significant mortality reduction in the verapamil-treated patients without congestive heart failure (7.7% vs. 11.8%; p = 0.02). In patients with CHF, there was a similar incidence of primary events (17.9% vs. 17.5%).
Verapamil therapy after acute MI was associated with a reduction in death and reinfarction but only patients without heart failure.
Am J Cardiol 1990;66:779–785.
Keywords: Drug-Related Side Effects and Adverse Reactions, Heart Failure, Coronary Disease, Verapamil, Calcium Channel Blockers
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