Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Role of ischemia in postinfarction heart failure: hypothetical considerations based on use of verapamil in the DAVIT II Study. Danish Study Group on Verapamil in Myocardial Infarction.

Research output: Contribution to journalJournal articleResearch

  • C M Jespersen
View graph of relations
Based on a retrospective analysis of the DAVIT II database, we attempted to propose subgroups of post-infarction patients with heart failure, who might benefit or not benefit from antiischemic medical intervention. In DAVIT II, patients were randomized in a double-blind fashion to either verapamil 360 mg/day or placebo in the second week after the infarct and followed up to 18 months. The endpoint was the first major event; that is, death or reinfarction. In patients with heart failure but no ischemia, the event rate was 17.6% in the verapamil-treated patients and 16.5% in the placebo group (hazard verapamil: 1.01; 95% CL: 0.57, 1.79). In patients with both heart failure and residual ischemia, the event rate was 11.3% and 17.8% in the verapamil and placebo groups, respectively (hazard verapamil: 0.60; 95% CL: 0.24, 1.52). Although the latter reduction in major events was not statistically significant, we propose, in accordance with other studies, that in postinfarction patients with both heart failure and residual myocardial ischemia, the harmful negative inotropic effects of antiischemic drugs might be outweighed by their antiischemic effects, by means of which the prognosis might be improved. Patients without ischemia but with heart failure may, however, be at a disadvantage from such treatment.
Translated title of the contributionRole of ischemia in postinfarction heart failure: hypothetical considerations based on use of verapamil in the DAVIT II Study. Danish Study Group on Verapamil in Myocardial Infarction.
Original languageEnglish
JournalCardiovascular Drugs and Therapy
Volume8
Issue number6
Pages (from-to)823-828
Number of pages6
ISSN0920-3206
Publication statusPublished - 1994

ID: 32554609