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Calcium channel blockers in myocardial infarction

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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:

  1. NICE (May 2013). Secondary prevention in primary and secondary care for patients following a myocardial infarction
  2. NICE (2020). Acute coronary syndromes.

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