Document Detail


The evolving role of medical therapy for chronic stable angina.
MedLine Citation:
PMID:  18611360     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The management of chronic stable angina has undergone considerable evolution over the past two decades. This article highlights the need for a comprehensive approach to management that includes carefully identifying cardiac risk factors, using therapeutic lifestyle interventions, aggressive, multifaceted medical therapy, and judiciously using myocardial revascularization. For patients whose ischemia cannot be optimally controlled with traditional anti-ischemic agents, a novel antianginal and anti-ischemic agent (ie, ranolazine) has promise in reducing refractory ischemia as add-on therapy. This article discusses the role of coronary artery bypass graft surgery and percutaneous coronary intervention (PCI) in managing chronic stable angina patients and the clinical implications of the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive drug Evaluation) trial. The combined use of a "focal" approach (PCI to treat the culprit stenosis) and a "systemic" approach (lifestyle intervention and aggressive pharmacotherapy) may afford the best event-free survival and clinical outcomes in patients with stable angina.
Authors:
Freidy Eid; William E Boden
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current cardiology reports     Volume:  10     ISSN:  1534-3170     ISO Abbreviation:  Curr Cardiol Rep     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-09     Completed Date:  2008-10-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888969     Medline TA:  Curr Cardiol Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  263-71     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Buffalo General Hospital, SUNY at Buffalo School of Medicine, 100 High Street, Buffalo, NY 14203, USA.
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MeSH Terms
Descriptor/Qualifier:
Acetanilides / therapeutic use
Angina Pectoris / drug therapy,  surgery,  therapy*
Angioplasty, Transluminal, Percutaneous Coronary*
Cardiovascular Agents / therapeutic use*
Chronic Disease
Combined Modality Therapy
Coronary Artery Bypass*
Disease-Free Survival
Enzyme Inhibitors / therapeutic use
Humans
Piperazines / therapeutic use
Platelet Aggregation Inhibitors / therapeutic use
Risk Factors
Risk Reduction Behavior*
Chemical
Reg. No./Substance:
0/Acetanilides; 0/Cardiovascular Agents; 0/Enzyme Inhibitors; 0/Piperazines; 0/Platelet Aggregation Inhibitors; 110445-25-5/ranolazine

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


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