Long-term mortality follow-up of hospital survivors of a myocardial infarction randomized to nifedipine in the SPRINT study

This study was intended to determine the 5-year mortality of 2138 post-myocardial infarction (MI) patients who took part in the Secondary Prevention Reinfarction Israeli Nifedipine Trial (SPRINT). In the framework of the SPRINT study, 1065 patients were randomly assigned 30 mg/d nifedipine therapy for a mean 10-month follow-up period, and 1073 received placebo. No information is available concerning treatment after the first year. One-year postdischarge mortality was 5.0% in the placebo group and 5.9% among patients receiving nifedipine (P = 0.37). Mortality rates after 5 years of follow-up in patients previously randomized to 1 year of nifedipine therapy and placebo were 18.4% and 18.3%, respectively. The 5-year mortality risk ratio associated with randomization to nifedipine over 1 year, adjusted for age, gender, past MI, angina, diabetes, hypertension, MI location, and therapy was 1.00 (95% CI: 0.81-1.22). Our results do not support an association between nifedipine therapy and a late harmful effect on long term mortality.