[Nifedipine in secondary prevention after myocardial infarction. SPRINT Study Group].

14 CCUs in Israel participated in a double-blind, placebo controlled, randomized trial of nifedipine, 30 mg/day, for the secondary prevention of myocardial infarction (MI). 2,276 patients were included in the study 7-21 days (mean, 12) after an acute MI. The study (SPRINT I) lasted for 1 year and no significant differences were found between nifedipine and placebo groups as regards mortality (5.8%, 5.7%) or recurrence of a nonfatal MI (4.7%, 5.1%). In another nifedipine study (SPRINT II) in high-risk patients with suspected MI, titration towards a 60 mg/day dose was begun as early as possible and in 75 it was started within 3 hours after the event. Of 1,358 patients randomized on admission, 826 fulfilled all the criteria for inclusion, gave informed consent, were included in the study by the 6th hospital day, and survived the titration period. Mortality was slightly greater in the initial titration stage in those randomized to nifedipine than in those randomized to the placebo group. In this second study with a larger dose, begun earlier and continued for 6 months, nifedipine was also ineffective in the secondary prevention of fatal or nonfatal MI. Therefore its use is not recommended in the routine preventive therapy of recurrent MI.

RCT Entities:   Population Interventions Outcomes