A meta-analysis of randomized trials of calcium antagonists to reduce restenosis after coronary angioplasty

In aggregate, 5 randomized trials involving 919 patients suggest that patients treated with calcium antagonists had approximately a 30% reduction in the odds of angiographic restenosis, which may translate into a meaningful clinical benefit.

Abstract

The usefulness of calcium antagonists to reduce restenosis after coronary angioplasty remains uncertain despite 5 randomized trials involving 919 patients. Review and meta-analysis of these trials are performed to provide insight into whether calcium antagonists reduce angiographic restenosis. In aggregate, these trials suggest that patients treated with calcium antagonists had approximately a 30% reduction in the odds of angiographic restenosis (odds ratio = 0.68; 95% confidence interval of 0.49 to 0.94, p = 0.03) compared with control patients. Given the relatively low toxicity and cost of these agents, this reduction in angiographic restenosis may translate into a meaningful clinical benefit. A large, randomized clinical trial should be performed to confirm these findings before widespread adoption of this treatment strategy.