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lüll Safety of nifedipine in angina pectoris: a meta-analysis Stason WB; Schmid CH; Niedzwiecki D; Whiting GW; Caubet JF; Cory D; Luo D; Ross SD; Chalmers TCHypertension 1999[Jan]; 33 (1): 24-31-Our objective was to compare cardiovascular event rates in patients with stable angina receiving nifedipine as monotherapy or combination therapy and in active drug controls. A MEDLARS search of published articles from 1966 to 1995 in English, French, German, Italian, or Spanish, supplemented by a manual search of bibliographies, identified 60 randomized controlled trials that met protocol criteria. Blinded articles were extracted by 2 physicians. The pooled risks of death, withdrawal, and cardiovascular event were computed and expressed as odds ratios (ORs) for all nifedipine formulations and relative to same study control drug regimens. Thirty cardiovascular events were reported in 2635 nifedipine exposures (1.14%) and 19 events in 2655 other active drug exposures (0.72%). Unadjusted ORs for nifedipine versus controls were 1.40 (95% CI, 0.56 to 3.49) for major events (death, nonfatal myocardial infarction, stroke, revascularization procedure), 1.75 (95% CI, 0.83 to 3.67) for increased angina, and 1.61 (95% CI, 0.91 to 2.87) for all events (major events plus increased angina). Episodes of increased angina were more frequent on immediate-release nifedipine (OR, 4.19 [95% CI, 1.41 to 12.49]) and on nifedipine monotherapy (OR, 2.61 [95% CI, 1.30 to 5.26]). The OR for immediate-release nifedipine was significantly higher than that for sustained-release/extended-release nifedipine (P=0.001), and the OR for nifedipine monotherapy was higher than that for nifedipine combination therapy (P=0.03). Increased risks of cardiovascular events in patients with stable angina on nifedipine were due primarily to more episodes of increased angina, confined to the immediate-release formulation and to nifedipine monotherapy.|Adrenergic beta-Antagonists/administration & dosage[MESH]|Angina Pectoris/complications/*drug therapy/mortality[MESH]|Calcium Channel Blockers/adverse effects/*therapeutic use[MESH]|Delayed-Action Preparations[MESH]|Dosage Forms[MESH]|Drug Therapy, Combination[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Nifedipine/administration & dosage/adverse effects/*therapeutic use[MESH]|Nitrates/administration & dosage[MESH]|Odds Ratio[MESH]|Placebos[MESH]|Prospective Studies[MESH]|Randomized Controlled Trials as Topic[MESH]|Risk Factors[MESH]|Safety[MESH]|Time Factors[MESH]|Vasodilator Agents/adverse effects/*therapeutic use[MESH] |