Therapy

Why?

• Nifedipine has no clear effect on mortality ^{a d} but causes side-effects ^a
• Verapamil and diltiazem reduce rates of reinfarction, but have no clear effect on mortality ^a or development of heart failure ^d

Verapamil or diltiazem reduces reinfarction

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
myocardial infarction or unstable angina a	verapamil or diltiazem	control	reinfarction at 6 weeks	7.5%	0.79 (0.67 to 0.94)	68 (43 to 240)

Nifedipine causes side-effects

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
myocardial infarction a	nifedipine	placebo	side-effects at 28 days	4.2%	2% (1% to 4%)	43 (27 to 98)