Calcium channel blockers for reducing cardiac morbidity after noncardiac surgery: a meta-analysis

source extracted confidence: high 2026-04-09
#calcium-channel-blockers #heart-diseases #hemodynamics #humans #myocardial-infarction

Calcium channel blockers for reducing cardiac morbidity after noncardiac surgery: a meta-analysis

Wijeysundera et al., 2003 | Anesth Analg | Meta Analysis

Citation

Wijeysundera Duminda N, Beattie W Scott. Calcium channel blockers for reducing cardiac morbidity after noncardiac surgery: a meta-analysis. Anesth Analg. 2003-Sep;97(3):634-641. doi:10.1213/01.ANE.0000081732.51871.D2

Abstract

Cardiac complications are the leading cause of death after noncardiac surgery. Despite theoretical benefits, calcium channel blockers (CCB) are not widely used in the perioperative setting. This systematic review assessed the efficacy of CCBs during noncardiac surgery. MEDLINE, EMBASE, Science Citation Index, PubMed, and reference lists were searched without language restriction for randomized controlled trials (RCT) evaluating CCBs during noncardiac surgery. Two reviewers independently abstracted data on death, myocardial infarction (MI), ischemia, supraventricular tachyarrhythmia (SVT), and congestive heart failure (CHF). Treatment effects were calculated as relative risks (RR) with 95% confidence intervals (CI). Eleven studies (1007 patients) were included. CCBs significantly reduced ischemia (RR, 0.49; 95% CI, 0.30-0.80; P = 0.004) and SVT (RR, 0.52; 95% CI, 0.37-0.72; P < 0.0001). CCBs were associated with trends towards reduced death and MI. In post hoc analyses, CCBs significantly reduced death/MI (RR, 0.35; 95% CI, 0.15-0.86; P = 0.02) and major morbid events (MME), defined as death, MI, or CHF (RR, 0.39; 95% CI, 0.17-0.89; P = 0.02). In subgroup analyses, diltiazem significantly reduced ischemia, SVT, death/MI, and MMEs. This meta-analysis shows CCBs significantly reduced ischemia, SVT, and combined end-points in the setting of noncardiac surgery. The majority of these benefits are attributable to diltiazem, suggesting the need for further evaluation of this drug in a large RCT.

Key Findings

The majority of these benefits are attributable to diltiazem, suggesting the need for further evaluation of this drug in a large RCT.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 1007
Age Range See abstract
Condition See abstract

MeSH Terms

  • Calcium Channel Blockers
  • Heart Diseases
  • Hemodynamics
  • Humans
  • Myocardial Infarction
  • Myocardial Ischemia
  • Postoperative Complications
  • Randomized Controlled Trials as Topic
  • Tachycardia, Supraventricular

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: calcium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09