Document Detail

Selection of drug therapy in stable angina pectoris.
MedLine Citation:
PMID:  9652879     Owner:  NLM     Status:  MEDLINE    
Drug therapy in stable angina has two aims: the prevention of major cardiac events (such as unstable angina, myocardial infarction, or death) and the control of chest pain and transient myocardial ischemia. Given the low incidence of major cardiac events in patients with stable angina, primary preventive studies are scarce because they require a large sample size and long-term follow-up. Thus far, only aspirin and some lipid-lowering agents have been shown to be effective for this purpose. Antiischemic drugs reduce the imbalance between myocardial oxygen demand and supply, either by reducing oxygen consumption or by increasing coronary blood flow. The ideal approach would be to target drug therapy against the ischemia-inducing factor in each patient. The characteristics of anginal symptoms do not seem to help in selecting medical therapy, whereas a standard exercise test and a provocative test of coronary vasoconstriction may provide useful information in order to select patients who will preferentially respond to either a beta-blocker or a calcium antagonist. The combination of two or more anti-ischemic drugs does not seem to be any more effective than an adequately titrated monotherapy in reducing the occurrence of myocardial ischemia in individual patients. Combination therapy in stable coronary artery disease should include an individually selected and optimally titrated anti-ischemic agent and aspirin, with the addition of a lipid-lowering agent in patients with even mild hypercholesterolemia.
S Savonitto; D Ardissino
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  12     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-09-10     Completed Date:  1998-09-10     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  197-210     Citation Subset:  IM    
Second Division of Cardiology, Ospedale Niguarda Ca' Granda, Milan, Italy.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Angina Pectoris / complications,  drug therapy*
Calcium Channel Blockers / therapeutic use*
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Calcium Channel Blockers

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