Efficacy of high dose diltiazem in patients with myocardial infarction caused by severe coronary spasm

  AIM  To investigate the clinical efficacy and safety of high dose diltiazem in patients with myocardial infarction induced by severe coronary spasm.

  METHODS  The clinical data of 10 patients with myocardial infarction caused by severe coronary artery spasm were retrospectively analyzed. All patients were treated with guideline-directed medical therapy and high-dose diltiazem 360 mg/d. The quality of life and the number of episodes of angina pectoris after treatment were assessed by Seattle Angina Questionnaire. All the patients were followed up for at least 1 year to observe whether the recurrence of myocardial infarction happened.

  RESULTS  After 4 weeks of treatment, the Seattle Angina Pectoris Scale score was significantly higher than the baseline level (P<0.05). One patient experienced dizziness and bradycardia after taking diltiazem 360 mg/d for 4 months. The dose of diltiazem was reduced to 180 mg/d for this patient and the patient had a recurrence of myocardial infarction. The remaining 9 patients had no recurrence of myocardial infarction and no obvious side effects and the dose used was well tolerated.

  CONCLUSION  In patients with severe coronary spasm, high dose diltiazem significantly reduces angina pectoris and prevents the recurrence of myocardial infarction induced by coronary artery spasm. Treatment with high dose diltiazem is significantly effective and safe in patients with severe coronary spasm.