[Calcium inhibitors and post-infarction].

Although the value of beta-blockers in secondary prevention of infarction has been largely demonstrated, the role of calcium channel blockers has remained controversial for a long time. However, some subgroups of infarction may benefit from these drugs: limited infarction, without Q wave, infarction without left ventricular dysfunction. The beneficial effect is essentially observed with bradycardic calcium channel blockers (diltiazem, verapamil) and provided treatment is deferred for several days after the acute phase of myocardial necrosis. In the light of the results of the DAVIT II and CRIS studies, verapamil is a reasonable alternative to beta-blockers in secondary prevention of infarction, when beta-blockers are contraindicated especially because of asthma or chronic respiratory failure. It can obviously be associated with other treatments with a demonstrated value in post-infarction (especially aspirin and angiotensin converting enzyme inhibitors).