Key result
Abrupt verapamil withdrawal increases angina recurrence ~67% compared to placebo withdrawal.
Why the study?
The potential hazards of abrupt withdrawal of verapamil after six months of treatment in patients with prior myocardial infarction were unclear.
Does abrupt withdrawal of verapamil increase the risk of worsening or reappearance of angina pectoris in patients six months post-myocardial infarction?
Comparison
Abrupt withdrawal of verapamil 120 mg t.i.d. vs placebo withdrawal
Design
Double-blind placebo-controlled randomized trial
Follow-up
Two to three weeks
Authors
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No withdrawal syndrome after abrupt verapamil cessation post-MI; leaves open whether tapering reduces angina recurrence in symptomatic patients.
RCT (n=472)
Double-blind
Yes
Does abrupt withdrawal of verapamil increase the risk of worsening or reappearance of angina pectoris in patients six months post-myocardial infarction?
Absolute Event Rate: 15% vs 9%
p-value: p=<0.05
Abrupt withdrawal of verapamil six months post-myocardial infarction leads to a mild but statistically significant increase in worsening or reappearance of angina pectoris, though no severe withdrawal syndrome was observed.
THE DANISH STUDY GROUP ON VERAPAMIL IN MYOCARDIAL INFARCTION (1984) conducted an RCT in Ischaemic heart disease (n=472). Verapamil vs. Placebo was evaluated on Worsening or reappearance of angina pectoris (p=<0.05). Abrupt withdrawal of verapamil after 6 months of treatment led to worsening or reappearance of angina pectoris in 15% of patients versus 9% in the placebo group (P<0.05).
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