ACUTE MYOCARDIAL-INFARCTION MORTALITY RELATED TO USE OF CALCIUM-ANTAGONISTS BEFORE ADMISSION TO HOSPITAL

We investigated whether prior use of calcium antagonists in 80 (16.8%) out of 477 patients (64% males) admitted with acute myocardial infarc tion (MI) had any impact on in-hospital mortality. Patients using calc ium antagonists were slightly older (74 years vs. 72 years, 2P = 0.039 ) than those not taking them and fewer were male patients. Previous MI , diabetes mellitus, and prior use of aspirin, beta-blockers, and long -acting nitrates were more frequent in patients on calcium antagonists . In contrast, fewer patients on calcium antagonists prior to symptoms received thrombolytic treatment (21.3% vs. 34.8%, 2P = 0.018). The st udy had an observational exposed/nonexposed design, and we looked for both crude and adjusted effects. Of the 83 patients (17.4%) who died d uring hospitalization, 18 patients were in the calcium antagonist grou p (22.5%). The odds ratio (OR) for these patients to die in the hospit al was 1.48 and the 95% confidence interval (CI) 0.78-2.78; 2P = 0.19. When adjusting for confounders (gender, age, smoking habit, previous MI, and diabetes mellitus, as well as prior use of aspirin, beta-block ers, long-acting nitrates, and thrombolytic treatment at entry) OR was 1.08 and 95% CI. 0.57-2.05; 2P = 0.85. Thus, we found no excess in-ho spital mortality in patients with acute MI using calcium antagonists p rior to the onset of symptoms.