MI and calcium channel blockers
Last edited 12/2020 and last reviewed 12/2020
NICE have issued guidance as to the use of calcium channel blockers post myocardial infarction (1,2):
- calcium channel blockers should not routinely be used to reduce cardiovascular risk after an MI
- if beta-blockers are contraindicated or need to be discontinued, diltiazem or verapamil may be considered for secondary prevention in patients without pulmonary congestion or left ventricular systolic dysfunction
- for patients who are stable after an MI, calcium channel blockers may be used to treat hypertension and/or angina
- for patients with heart failure, amlodipine should be used, and verapamil, diltiazem and short-acting dihydropyridine agents should be avoided
Notes:
therapeutic trials testing the efficacy of calcium channel blockers in the management of acute myocardial infarction include the SPRINT trial.
Reference:
- NICE (May 2013). Secondary prevention in primary and secondary care for patients following a myocardial infarction
- NICE (2020). Acute coronary syndromes.