Effect of verapamil on mortality and major events after acute myocardial infarction (the Danish Verapamil Infarction Trial II--DAVIT II)
Effect of verapamil on mortality and major events after acute myocardial infarction (the Danish Verapamil Infarction Trial II--DAVIT II)
复制标题
DOI：
10.1016/0002-9149(90)90351-z
复制
发表时间：
1990
期刊：
影响因子：
--
通讯作者：
J. Hansen
中科院分区：
文献类型：
--
作者：
J. Hansen
在一项双盲、随机、安慰剂对照的多中心试验中，研究了维拉帕米对急性心肌梗死后死亡和重大事件(即死亡或再梗塞)的影响。878名患者开始服用维拉帕米，每天360毫克，897名患者服用安慰剂。治疗在入院后第二周开始，最长持续18个月(平均16个月)。维拉帕米组发生95例死亡和146例重大事件，安慰剂组发生119例死亡和180例重大事件。维拉帕米组和安慰剂组的18个月死亡率分别为11.1%和13.8%(p=0.11，危险比为0.80；95%可信区间为0.61~1.05)，重大事件发生率分别为18.0%和21.6%(p=0.03，危险比为0.80；95%可信区间为0.64~0.99)。在冠状动脉护理病房中无心力衰竭的患者中，维拉帕米组和安慰剂组的死亡率分别为7.7%和11.8%(p=0.02，危险比0.64；95%可信区间0.44至0.94)，重大事件发生率14.6%和19.7%(p=0.01，危险比0.70；95%可信区间0.52至0.93)。心力衰竭患者的死亡率分别为17.9%和17.5%(P=0.79，危险比1.05；95%可信区间0.72~1.54)，重大事件发生率24.9%和24.9%(P=1.0，危险比0.98；95%可信区间0.72~1.39)。急性心肌梗死后长期服用维拉帕米可显著减少重大事件的发生，且对无心衰的患者有积极作用。
The effect of verapamil on death and major events (i.e., death or reinfarction) after an acute myocardial infarction was studied in a double-blind, randomized, placebo-controlled multicenter trial. Eight hundred seventy-eight patients started treatment with verapamil, 360 mg/day, and 897 patients with placebo. Treatment started in the second week after admission and continued for up to 18 months (mean 16 months). Ninety-five deaths and 146 major events occurred in the verapamil group and 119 deaths and 180 major events in the placebo group. The 18-month mortality rates were 11.1 and 13.8% (p = 0.11, hazard ratio, 0.80; 95% confidence limits, 0.61 to 1.05), and major event rates 18.0 and 21.6% (p = 0.03, hazard ratio, 0.80; 95% confidence limits, 0.64 to 0.99) in the verapamil and placebo groups, respectively. In patients without heart failure in the coronary care unit the mortality rates were 7.7% in the verapamil group and 11.8% in the placebo group (p = 0.02, hazard ratio, 0.64; 95% confidence limits, 0.44 to 0.94), and major event rates 14.6 and 19.7% (p = 0.01, hazard ratio 0.70; 95% confidence limits (0.52 to 0.93). In patients with heart failure the mortality rates were 17.9 and 17.5% (p = 0.79, hazard ratio, 1.05; 95% confidence limits, 0.72 to 1.54), and major event rates 24.9 and 24.9% (p = 1.0, hazard ratio 0.98; 95% confidence limits 0.72 to 1.39).Long-term treatment with verapamil after an acute myocardial infarction caused a significant reduction in major events, and the positive effect was found in patients without heart failure.