Multicenter diltiazem postinfarction trial

The Multicenter Diltiazem Postinfarction Trial Reseach Group. The effect of diltiazem on mortality and reinfarction after myocardial infarction. N Engl J Med 1998 319 385-92. 

It has been argued that dihydropyridine calcium channel blockers, which increase heart rate, can all increase the risk of death and reinfarction (35,36). Early beneficial results with diltiazem in patients with non-Q-wave infarction (37) were not confirmed in the Multicenter Diltiazem Postinfarction Trial (38). In patients with pulmonary congestion, diltiazem was associated with an increase in cardiac events, and there was a similar result in patients with low ejection fractions. However, verapamil does appear to reduce reinfarction (39), a benefit that is more marked in those without heart failure (40). Nifedipine may also have a detrimental effect in unstable angina it certainly appears to offer no benefit (41). 

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