Stable Angina Pectoris: Current Medical Treatment

Katerina      Siama; Dimitris      Tousoulis; Nikolaos      Papageorgiou; Gerasimos      Siasos; Eleftherios      Tsiamis; Constantinos      Bakogiannis; Alexandros      Briasoulis; Emmanuel      Androulakis; Kostas      Tentolouris; Christodoulos      Stefanadis

Abstract

Stable angina represents the main symptom of established coronary artery disease. In addition atherosclerosis is the common pathological substrate of chronic stable angina as well as acute coronary syndromes. The aim of stable angina management is the symptomatic relief and the secondary prevention. Lifestyle modification and pharmacological therapy are the cornerstones of chronic coronary artery disease management irrespectively of possible surgical or percutaneous revascularization. Optimal medical therapy is a combination of antianginal/antiischemic drugs and disease modifying agents, including nitrates, beta-blockers, calcium channel blockers, antiplatelets, statins and angiotensin converting enzyme inhibitors. Novel classes of treatment with different mechanisms of action have been developed in the last years, including nicorandil, ivabradine, trimetazidine and ranolazine. These drugs, which are currently approved as second-line treatments, have dynamically entered the clinical practice and their long-term effects are still under investigation.

Keywords: Stable angina pectoris treatment, atherosclerosis, myocardial ischemia, chronic coronary artery disease, angiotensin converting enzyme inhibitors, antiischemic drugs, acute coronary syndromes, ivabradine, trimetazidine, ranolazine