Calcium channel blockers: an intraoperative and postoperative trial in women.

This study analyzes the effects of intraoperative and postoperative calcium channel blockers on myocardial protection, postoperative arrhythmias, perioperative infarctions, and survival. Thirty-nine women undergoing consecutive coronary artery bypass operations were placed either in a control group (N = 23), in which standard cold potassium cardioplegia was used, or in a verapamil-nifedipine group (N = 16), in which verapamil (1 mg per liter) was added to the standard cardioplegic solution and nifedipine was instituted postoperatively. The verapamil-nifedipine group showed a significant reduction in postoperative levels of creatine phosphokinase (p less than 0.05). Levels of aspartate aminotransferase were also reduced (74 IU/L) compared with those for the control group (114 IU/L). In the control group, there were 3 early deaths secondary to abrupt ventricular fibrillation, but no patient in the verapamil-nifedipine group died or had serious early ventricular arrhythmias. Late hemodynamic variables were similar in both groups. We conclude that calcium channel blockers enhance myocardial protection during ischemic arrest and may diminish the incidence of fatal early postoperative ventricular arrhythmias in women undergoing coronary revascularization.

RCT Entities:   Population Interventions Outcomes