Document Detail


Therapeutic approach in patients with stable angina.
MedLine Citation:
PMID:  15773267     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Which therapeutic strategy among medical, interventional and surgical options should be preferred in patients with chronic stable ischemic heart disease is an important public health problem. The available scientific evidence does not help much to facilitate the choice among the three available strategies of medical treatment, percutaneous coronary intervention and coronary artery bypass grafting. In this area practice-based medicine overwhelms evidence-based medicine. However, existing findings are discussed. The present experience in diabetic patients is highlighted; in such patients surgery is generally recommended but the results obtained by percutaneous coronary intervention with the currently available tools are improving markedly. Pharmacological therapy is also improving, particularly in the prevention of the progression of atherothrombosis and consequently of cardiovascular events. Actually two categories of drugs should be recognized: those prescribed to prevent death and myocardial infarction and those with antianginal and anti-ischemic effects aimed at alleviating symptoms and reducing ischemia. The first group of drugs includes antiplatelet-antithrombotic agents, lipid-lowering agents and angiotensin-converting enzyme inhibitors; the second group includes beta-blockers, calcium antagonists and nitrates. A good integration of the two classes of drugs, combined with an appropriate use of coronary revascularization procedures, should yield the maximum possible benefit in the individual patient.
Authors:
Maddalena Lettino; Colomba Falcone; Luigi Tavazzi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Italian heart journal : official journal of the Italian Federation of Cardiology     Volume:  6     ISSN:  1129-471X     ISO Abbreviation:  Ital Heart J     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-03-18     Completed Date:  2005-06-09     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  100909716     Medline TA:  Ital Heart J     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  1-8     Citation Subset:  IM    
Affiliation:
Coronary Care Unit, IRCCS San Matteo Hospital, Pavia, Italy. m.lettino@smatteo.pv.it
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Angina Pectoris / therapy*
Angioplasty, Transluminal, Percutaneous Coronary
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Antilipemic Agents / therapeutic use
Calcium Channel Blockers / therapeutic use
Chronic Disease
Coronary Artery Bypass
Coronary Thrombosis / prevention & control
Decision Making
Fibrinolytic Agents / therapeutic use
Humans
Myocardial Revascularization / methods*
Platelet Aggregation Inhibitors / therapeutic use
Vasodilator Agents / therapeutic use
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antilipemic Agents; 0/Calcium Channel Blockers; 0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors; 0/Vasodilator Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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