Benidipine significantly reduced the risk of major adverse cardiovascular events (HR 0.41) compared to other treatments in Japanese patients with vasospastic angina.
Meta-Analysis (n=1,997)
Does benidipine reduce major adverse cardiovascular events in Japanese patients with vasospastic angina compared to other calcium channel blockers?
In Japanese patients with vasospastic angina, treatment with benidipine was associated with a significantly lower risk of major adverse cardiovascular events compared to other calcium channel blockers.
Hazard Ratio: 0.41 (95% CI 0.2–0.85)
p-value: p=0.016
Background: Although calcium channel blockers (CCB) are highly effective for suppression of vasospastic angina (VSA) attacks, their prognostic effects in VSA patients remain to be examined in a large number of patients. Methods and Results: Databases for related papers were searched and then a meta-analysis regarding the effects of CCB on major adverse cardiovascular events (MACE) in Japanese VSA patients with the 4 previous studies was performed. A total of 1,997 patients with positive coronary spasm provocation tests were evaluated. They were treated with either alone or combination of benidipine (n=320), amlodipine (n=308), nifedipine (n=182) or diltiazem (n=960). MACE were observed in 143 patients (cardiac death: 36, myocardial infarction: 51, heart failure: 26, stroke: 65, and aortic aneurysm: 11). The hazard ratio for the occurrence of MACE was significantly lower in patients treated with benidipine than in those with diltiazem. There was no significant difference in the clinical characteristics affecting the occurrence of MACE among the 4 CCB groups. Furthermore, the hazard ratio for the occurrence of MACE was significantly lower in those treated with benidipine, even after correction for patient characteristics that could have affected the occurrence of MACE (hazard ratio 0.41, P=0.016). Conclusions: These results suggest that among the 4 major CCB that effectively suppress VSA attacks in general, benidipine showed significantly more beneficial prognostic effects than others. (Circ J 2010; 74: 1943 - 1950)
Nishigaki et al. (Fri,) conducted a meta-analysis in Vasospastic angina (n=1,997). Benidipine vs. Other calcium channel blockers (amlodipine, nifedipine, diltiazem) or no benidipine was evaluated on Major adverse cardiovascular events (MACE) (HR 0.41, 95% CI 0.20-0.85, p=0.016). Benidipine significantly reduced the risk of major adverse cardiovascular events (HR 0.41) compared to other treatments in Japanese patients with vasospastic angina.