A CONTROLLED TRIAL OF VERAPAMIL IN PATIENTS AFTER ACUTE MYOCARDIAL-INFARCTION - RESULTS OF THE CALCIUM-ANTAGONIST REINFARCTION ITALIAN STUDY (CRIS)

A multicenter, double-blind, randomized, placebo-controlled trial was conducted to assess the effects of verapamil on total mortality, cardi ac mortality, reinfarction, and angina after an acute myocardial infar ction. All patients, aged 30 to 75 years, consecutively admitted for a cute myocardial infarction between 1985 and 1987 to the participating centers, and without contraindications to verapamil or history of seve re heart failure were enrolled. Seven to 21 days (mean 13.8) after myo cardial infarction, 531 patients were randomized to verapamil retard 3 60 mg/day, and 542 patients to placebo. At baseline, the 2 groups of p atients had similar characteristics. Mean age was 55.5 years and 91% w ere men. During a mean follow-up of 23.5 months, 5.5% of the patients died. No differences between verapamil and placebo were observed in to tal mortality (n = 30 and 29, respectively) and cardiac death (n = 21 and 22, respectively). The verapamil group had nonsignificant lower re infarction rates (n = 39 vs 49). The number of patients developing ang ina was significantly less in the verapamil group (n = 100 vs 132, RR = 0.8, 95% confidence interval 0.5 to 0.9). There were no differences in discontinuation of therapy caused by adverse reactions. This trial showed no effect of verapamil on mortality. The lower reinfarction rat es found in the verapamil group are in agreement with the results of o ther studies.