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Calcium channel blockers in myocardial infarction

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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