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Journal articles on the topic 'Chronic stable angina'

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Published: 10 March 2023

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1

Abrams, Jonathan. "Chronic Stable Angina." New England Journal of Medicine 352, no. 24 (June 16, 2005): 2524–33. http://dx.doi.org/10.1056/nejmcp042317.

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2

Ohman, E. Magnus. "Chronic Stable Angina." New England Journal of Medicine 374, no. 12 (March 24, 2016): 1167–76. http://dx.doi.org/10.1056/nejmcp1502240.

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3

M Elshafae, Mohamed, Jehan H. Sabry, Mohamed A Salem, and Hanan M Elshafee. "MicroRNA-155 in patients with Chronic Stable Angina." Annals of Applied Bio-Sciences 4, no. 1 (March 2017): A74—A82. http://dx.doi.org/10.21276/aabs.2017.1383.

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4

&NA;. "Chronic stable angina pectoris." Inpharma Weekly &NA;, no. 1193 (June 1999): 4. http://dx.doi.org/10.2165/00128413-199911930-00006.

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5

Dalal, J. N., and A. C. Jain. "Chronic stable angina pectoris." Postgraduate Medicine 91, no. 4 (March 1992): 165–77. http://dx.doi.org/10.1080/00325481.1992.11701251.

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6

Thadani, Udho, and Asim Chohan. "Chronic stable angina pectoris." Postgraduate Medicine 98, no. 6 (December 1995): 175–88. http://dx.doi.org/10.1080/00325481.1995.11946093.

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7

Higginbotham, Michael B., Kenneth G. Morris, R. Edward Coleman, and Frederick R. Cobb. "Chronic stable angina monotherapy." American Journal of Medicine 86, no. 1 (January 1989): 1–5. http://dx.doi.org/10.1016/0002-9343(89)90002-8.

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8

Jawad, Evyan, and Rohit Arora. "Chronic Stable Angina Pectoris." Disease-a-Month 54, no. 9 (September 2008): 671–89. http://dx.doi.org/10.1016/j.disamonth.2008.06.009.

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9

Berra, Kathy, Barbara Fletcher, and Nancy Houston Miller. "Chronic stable angina: Addressing the needs of patients through risk reduction, education and support." Clinical & Investigative Medicine 31, no. 6 (December 1, 2008): 391. http://dx.doi.org/10.25011/cim.v31i6.4927.

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Chronic stable angina (CSA) is one of the most common symptoms experienced by persons with heart disease. CSA is defined by the physical symptoms resulting from blockage of blood flow through the coronary arteries. Anginal symptoms generally occur as a result of increased demands for blood flow, such as with physical activity, eating a large meal, emotional upset or exposure to cold weather. Symptoms vary widely and can include discomfort in the chest, arms, back and jaw, shortness of breath and a sense of increased fatigue. Many patients with chronic stable angina do not describe their symptoms as “pain” but have a sense of burning, tightness, pressure or heaviness in the chest and upper body. Chronic stable angina is usually relieved by stopping the activity that precipitated the symptoms, by resting, and by the use of Nitroglycerine. Anginal symptoms are called “chronic and stable” when they occur in a predictable fashion and are in response to “triggers” such as those mentioned above.
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10

&NA;. "Management of chronic stable angina." Inpharma Weekly &NA;, no. 1315 (November 2001): 3. http://dx.doi.org/10.2165/00128413-200113150-00004.

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11

BEATTIE, SALLY. "Management of Chronic Stable Angina." Nurse Practitioner 24, no. 5 (May 1999): 44???61. http://dx.doi.org/10.1097/00006205-199905000-00004.

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12

O'Toole, L. "Chronic stable angina: treatment options." BMJ 326, no. 7400 (May 29, 2003): 1185–88. http://dx.doi.org/10.1136/bmj.326.7400.1185.

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13

Nash, David T., and Stephen D. Nash. "Ranolazine for chronic stable angina." Lancet 372, no. 9646 (October 2008): 1335–41. http://dx.doi.org/10.1016/s0140-6736(08)61554-8.

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14

Gamham, S. P., K. Gunawardena, U. Hauf-Zacharlou, and R. A. Blackwood. "Carvedilol in chronic stable angina." Clinical Pharmacology & Therapeutics 59, no. 2 (February 1996): 163. http://dx.doi.org/10.1038/sj.clpt.1996.152.

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15

Gupta, Prabha Nini, Praveen Velappan, Krishna Kumar Bhaskara Pillai, and Riyas Abdul Salam. "Re chronic stable angina guidelines." Indian Heart Journal 69, no. 1 (January 2017): 129–32. http://dx.doi.org/10.1016/j.ihj.2017.01.004.

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16

Walters, Michele Ann. "Management of Chronic Stable Angina." Critical Care Nursing Clinics of North America 29, no. 4 (December 2017): 487–93. http://dx.doi.org/10.1016/j.cnc.2017.08.008.

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17

Padala, Santosh K., Michael P. Lavelle, Mandeep S. Sidhu, Katherine P. Cabral, Doralisa Morrone, William E. Boden, and Peter P. Toth. "Antianginal Therapy for Stable Ischemic Heart Disease." Journal of Cardiovascular Pharmacology and Therapeutics 22, no. 6 (March 31, 2017): 499–510. http://dx.doi.org/10.1177/1074248417698224.

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Chronic angina pectoris is associated with considerable morbidity and mortality, especially if treated suboptimally. For many patients, aggressive pharmacologic intervention is necessary in order to alleviate anginal symptoms. The optimal treatment of stable ischemic heart disease (SIHD) should be the prevention of angina and ischemia, with the goal of maximizing both quality and quantity of life. In addition to effective risk factor modification with lifestyle changes, intensive pharmacologic secondary prevention is the therapeutic cornerstone in managing patients with SIHD. Current guidelines recommend a multifaceted therapeutic approach with β-blockers as first-line treatment. Another important pharmacologic intervention for managing SIHD is nitrates. Nitrates can provide both relief of acute angina and can be used prophylactically before exposure to known triggers of myocardial ischemia to prevent angina. Additional therapeutic options include calcium channel blockers and ranolazine, an inhibitor of the late inward sodium current, that can be used alone or in addition to nitrates or β-blockers when these agents fail to alleviate symptoms. Ranolazine appears to be particularly effective for patients with microvascular angina and endothelial dysfunction. In addition, certain antianginal therapies are approved in Europe and have been shown to improve symptoms, including ivabradine, nicorandil, and trimetazidine; however, these have yet to be approved in the United States. Ultimately, there are several different medications available to the physician for managing the patient with SIHD having chronic angina, when either used alone or in combination. The purpose of this review is to highlight the most important therapeutic approaches to optimizing contemporary treatment in response to individual patient needs.
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18

Mesnier, Jules, Gregory Ducrocq, Nicolas Danchin, Roberto Ferrari, Ian Ford, Jean-Claude Tardif, Michal Tendera, Kim M. Fox, and Philippe Gabriel Steg. "International Observational Analysis of Evolution and Outcomes of Chronic Stable Angina: The Multinational CLARIFY Study." Circulation 144, no. 7 (August 17, 2021): 512–23. http://dx.doi.org/10.1161/circulationaha.121.054567.

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Background: Although angina is common in patients with stable coronary artery disease, limited data are available on its prevalence, natural evolution, and outcomes in the era of effective cardiovascular drugs and widespread use of coronary revascularization. Methods: Using data from 32 691 patients with stable coronary artery disease from the prospective observational CLARIFY registry (Prospective Observational Longitudinal Registry of Patients with Stable Coronary Artery Disease), anginal status was mapped each year in patients without new coronary revascularization or new myocardial infarction. The use of medical interventions in the year preceding angina resolution was explored. The effect of 1-year changes in angina status on 5-year outcomes was analyzed using multivariable analysis. Results: Among 7212 (22.1%) patients who reported angina at baseline, angina disappeared (without coronary revascularization) in 39.6% at 1 year, with further annual decreases. In patients without angina at baseline, 2.0% to 4.8% developed angina each year. During 5-year follow-up, angina was controlled in 7773 patients, in whom resolution of angina was obtained with increased use of antianginal treatment in 11.1%, with coronary revascularization in 4.5%, and without any changes in medication or revascularization in 84.4%. Compared to patients without angina at baseline and 1 year, persistence of angina and occurrence of angina at 1 year with conservative management were each independently associated with higher rates of cardiovascular death or myocardial infarction (adjusted hazard ratio, 1.32 [95% CI, 1.12−1.55] for persistence of angina; adjusted hazard ratio, 1.37 [95% CI, 1.11−1.70] for occurrence of angina) at 5 years. Patients whose angina had resolved at 1 year with conservative management were not at higher risk of cardiovascular death or myocardial infarction than those who never experienced angina (adjusted hazard ratio, 0.97 [95% CI, 0.82−1.15]). Conclusions: Angina affects almost one-quarter of patients with stable coronary artery disease but resolves without events or coronary revascularization in most patients. Resolution of angina within 1 year with conservative management predicted outcomes similar to lack of angina, whereas persistence or occurrence was associated with worse outcomes. Because most patients with angina are likely to experience resolution of symptoms, and because there is no demonstrated outcome benefit to routine revascularization, this study emphasizes the value of conservative management of stable coronary artery disease. Registration: URL: https://www.isrctn.com ; Unique identifier: ISRCTN43070564.
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19

Trujillo, Toby C., and Paul P. Dobesh. "Traditional Management of Chronic Stable Angina." Pharmacotherapy 27, no. 12 (December 2007): 1677–92. http://dx.doi.org/10.1592/phco.27.12.1677.

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20

Wee, Yong, Kylie Burns, and Nicholas Bett. "Medical management of chronic stable angina." Australian Prescriber 38, no. 4 (August 1, 2015): 131–36. http://dx.doi.org/10.18773/austprescr.2015.042.

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21

Staniforth, Andrew D. "Contemporary Management of Chronic Stable Angina." Drugs & Aging 18, no. 2 (2001): 109–21. http://dx.doi.org/10.2165/00002512-200118020-00004.

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22

&NA;. "Nicorandil beneficial in chronic stable angina." Inpharma Weekly &NA;, no. 1334 (April 2002): 14. http://dx.doi.org/10.2165/00128413-200213340-00027.

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23

&NA;. "Arginine beneficial in chronic stable angina?" Inpharma Weekly &NA;, no. 1326 (February 2002): 13. http://dx.doi.org/10.2165/00128413-200213260-00029.

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24

Wong, John B. "Myocardial Revascularization for Chronic Stable Angina." Annals of Internal Medicine 113, no. 11 (December 1, 1990): 852. http://dx.doi.org/10.7326/0003-4819-113-11-852.

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25

Kaski, Juan-Carlos, Antonio Arrebola-Moreno, and Jason Dungu. "Treatment strategies for chronic stable angina." Expert Opinion on Pharmacotherapy 12, no. 18 (November 18, 2011): 2833–44. http://dx.doi.org/10.1517/14656566.2011.634799.

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26

Messenger, John C., and John D. Carroll. "Outpatient Management of Chronic Stable Angina." Primary Care Case Reviews 1, no. 4 (December 1998): 168–80. http://dx.doi.org/10.1097/00129300-199801040-00003.

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27

Dixit, Deepali, and Katarzyna Kimborowicz. "Pharmacologic management of chronic stable angina." Journal of the American Academy of Physician Assistants 28, no. 6 (June 2015): 1–8. http://dx.doi.org/10.1097/01.jaa.0000465223.98395.45.

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28

Richard, C. "Refractory chronic stable angina-now what?" Clinical Cardiology 27, no. 7 (July 2004): 375–76. http://dx.doi.org/10.1002/clc.4960270701.

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29

Reichek, Nathaniel. "Nitroglycerin in chronic stable angina pectoris." American Journal of Cardiology 60, no. 15 (November 1987): H15—H17. http://dx.doi.org/10.1016/0002-9149(87)90545-5.

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30

Myers, G. Robert, and William S. Weintraub. "Medical therapies for chronic stable angina." Current Cardiovascular Risk Reports 2, no. 5 (September 2008): 350–58. http://dx.doi.org/10.1007/s12170-008-0063-7.

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31

Gorlin, Richard. "Treatment of chronic stable angina pectoris." American Journal of Cardiology 70, no. 17 (November 1992): G26—G31. http://dx.doi.org/10.1016/0002-9149(92)90022-q.

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32

Vadnais, David S., and Nanette K. Wenger. "Management Options in Chronic Stable Angina Pectoris: Focus on Ranolazine." Clinical Medicine. Therapeutics 1 (January 2009): CMT.S2214. http://dx.doi.org/10.4137/cmt.s2214.

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Chronic stable angina pectoris results from a fixed coronary arterial obstruction causing an imbalance between myocardial oxygen supply and demand. Current therapy aims to reduce cardiovascular events (vasculoprotective) thereby improving survival, and/or relieve ischemic symptoms (antianginal) thereby improving the quality of life. Vasculoprotective therapy consists of lifestyle modification, antiplatelet agents, lipid lowering therapy and angiotensin-converting enzyme (ACE) inhibitors. Conventional antianginal therapy for patients with chronic stable angina consists of beta-blockers, calcium channel blockers and nitrates, with surgical or percutaneous revascularization serving an adjunctive role. Despite the investigation of multiple novel therapies and medications over the past 25 years, arguably the most significant contribution to antianginal therapy during that time involved the recent introduction of ranolazine. Ranolazine acts via a distinctive pathway, inhibiting the late sodium current of the action potential in ischemic myocytes. Multiple studies have demonstrated that ranolazine significantly reduces anginal symptoms and improves exercise performance in patients with chronic stable angina but does not reduce mortality. Ranolazine does not affect either heart rate or blood pressure, a unique property among the current antianginal agents. Despite its QT prolongation, ranolazine has a proven safety profile and is not proarrhythmic. In fact, in a recent large randomized trial, ranolazine reduced the incidence of supraventricular tachycardia, ventricular tachycardia, new-onset atrial fibrillation and bradycardic events. Ranolazine may confer some additional benefits such as a reduction in HbA1c levels and improved left ventricular diastolic function. Ranolazine is now approved for use in chronic stable angina. Current guidelines recommend beta-blockers as the first line antianginal agent due to the proven mortality reduction. However, for patients with bradycardia or hypotension, ranolazine may be considered as initial antianginal therapy.
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33

Galderisi, M., A. Celentano, G. Mossetti, M. Garofalo, G. F. Mureddu, P. Tammaro, E. Gravina, and O. de Divitiis. "Effects of Nicardipine on Chronic Stable Effort Angina: a Non-Invasive Assessment." Journal of International Medical Research 16, no. 5 (September 1988): 349–58. http://dx.doi.org/10.1177/030006058801600504.

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The effects of 60 mg/day nicardipine hydrochloride were evaluated in a 4-week single-blind study on 12 patients with chronic stable effort angina. All patients completed the treatment with few reports of adverse effects. Nicardipine hydrochloride was effective in reducing the incidence of anginal attacks and consumption of glyceryl trinitrate. Treadmill exercise time, angina onset time and the time to 1 mm ST-segment depression were increased. The extent of ST-segment depression was reduced at maximum comparable exercise, with a reduced rate–pressure product and, at maximum exercise, with an increased rate–pressure product. Myocardial stress 201Tl scintillography was carried out in eight of the patients and showed improved washout in antero-septal, infero-apical and postero-lateral segments. Echocardiographic measures of left ventricular function were enhanced because of reduction of afterload. Systemic vascular resistance and end-systolic stress were also decreased and a significant correlation was found between the increase in ejection fraction and reduction of systolic blood pressure. It is concluded that nicardipine hydrochloride is effective in the control of stable effort angina by reducing myocardial oxygen consumption and enhancing coronary blood flow thereby improving left ventricular function.
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34

Tarkin, Jason M., and Juan Carlos Kaski. "Pharmacological treatment of chronic stable angina pectoris." Clinical Medicine 13, no. 1 (February 2013): 63–70. http://dx.doi.org/10.7861/clinmedicine.13-1-63.

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35

Maseri, A. "Medical therapy of chronic stable angina pectoris." Circulation 82, no. 6 (December 1990): 2258–62. http://dx.doi.org/10.1161/01.cir.82.6.2258.

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36

Thadani, Udho. "Current Medical Management of Chronic Stable Angina." Journal of Cardiovascular Pharmacology and Therapeutics 9, no. 1_suppl (March 2004): S11—S29. http://dx.doi.org/10.1177/107424840400900103.

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37

Toutouzas, Konstantinos, Antonis Karanasos, Maria Drakopoulou, Eleutherios Tsiamis, Andreas Synetos, Stamatios Lerakis, Christodoulos Stefanadis, and Stamatios Lerakis. "Percutaneous Coronary Intervention in Chronic Stable Angina." American Journal of the Medical Sciences 339, no. 6 (June 2010): 568–72. http://dx.doi.org/10.1097/maj.0b013e3181d673d7.

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38

Staniforth, Andrew D. "Evidence based treatment of chronic stable angina." International Journal of Cardiology 63, no. 1 (January 1998): 21–25. http://dx.doi.org/10.1016/s0167-5273(97)00286-6.

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39

Bundy, Christine, Douglas Carroll, Louise Wallace, and Robert Nagle. "Psychological treatment of chronic stable angina pectoris." Psychology & Health 10, no. 1 (December 1994): 69–77. http://dx.doi.org/10.1080/08870449408401937.

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40

Holmes, David R., Bernard J. Gersh, Patrick Whitlow, Spencer B. King, and James T. Dove. "Percutaneous Coronary Intervention for Chronic Stable Angina." JACC: Cardiovascular Interventions 1, no. 1 (February 2008): 34–43. http://dx.doi.org/10.1016/j.jcin.2007.10.001.

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41

Krikler, Dennis M. "Calcium antagonists for chronic stable angina pectoris." American Journal of Cardiology 59, no. 3 (January 1987): B95—B100. http://dx.doi.org/10.1016/0002-9149(87)90088-9.

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42

Friedewald, Vincent E., Spencer B. King, Carl J. Pepine, George W. Vetrovec, and William C. Roberts. "The Editor’s Roundtable: Chronic Stable Angina Pectoris." American Journal of Cardiology 100, no. 11 (December 2007): 1635–43. http://dx.doi.org/10.1016/j.amjcard.2007.09.001.

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43

O'Rourke, Robert A. "Cost-effective management of chronic stable angina." Clinical Cardiology 19, no. 6 (June 1996): 497–501. http://dx.doi.org/10.1002/clc.4960190611.

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44

Richard Conti, C. "Medical device therapy for chronic stable angina." Clinical Cardiology 21, no. 2 (February 1998): 71. http://dx.doi.org/10.1002/clc.4960210202.

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45

Aldakkak, Mohammed, David F. Stowe, and Amadou K. S. Camara. "Safety and Efficacy of Ranolazine for the Treatment of Chronic Angina Pectoris." Clinical Medicine Insights: Therapeutics 5 (January 2013): CMT.S7824. http://dx.doi.org/10.4137/cmt.s7824.

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Coronary heart disease is a global malady and it is the leading cause of death in the United States. Chronic stable angina is the most common manifestation of coronary heart disease and it results from the imbalance between myocardial oxygen supply and demand due to reduction in coronary blood flow. Therefore, in addition to lifestyle changes, commonly used pharmaceutical treatments for angina (nitrates, β-blockers, Ca2+ channel blockers) are aimed at increasing blood flow or decreasing O2 demand. However, patients may continue to experience symptoms of angina. Ranolazine is a relatively new drug with anti-anginal and anti-arrhythmic effects. Its anti-anginal mechanism is not clearly understood but the general consensus is that ranolazine brings about its anti-anginal effects by inhibiting the late Na+ current and the subsequent intracellular Ca2+ accumulation. Recent studies suggest other effects of ranolazine that may explain its anti-anginal and anti-arrhythmic effects. Nonetheless, clinical trials have proven the efficacy of ranolazine in treating chronic angina. It has been shown to be ineffective, however, in treating acute coronary syndrome patients. Ranolazine is a safe drug with minimal side effects. It is metabolized mainly in the liver and cleared by the kidney. Therefore, caution must be taken in patients with impaired hepatic or renal function. Due to its efficacy and safety, ranolazine was approved for the treatment of chronic angina by the Food and Drug Administration (FDA) in 2006.
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46

Arora, Rohit. "Utility of ranolazine in chronic stable angina patients." Vascular Health and Risk Management Volume 4 (August 2008): 819–24. http://dx.doi.org/10.2147/vhrm.s2841.

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47

&NA;. "Lercanidipine 'safe' in patients with chronic stable angina." Reactions Weekly &NA;, no. 850 (May 2001): 4. http://dx.doi.org/10.2165/00128415-200108500-00006.

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48

Jackson, Janet Marianne. "Ivabradine – a novel treatment for chronic stable angina." Drugs in Context 4 (2008): 1–18. http://dx.doi.org/10.7573/dic.212225.

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49

Norton, Catherine, Vasiliki Georgiopoulou, Andreas Kalogeropoulos, and Javed Butler. "Chronic stable angina: pathophysiology and innovations in treatment." Journal of Cardiovascular Medicine 12, no. 3 (March 2011): 218–19. http://dx.doi.org/10.2459/jcm.0b013e328343e974.

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50

Zerumsky, Kristin, and Brian F. McBride. "Ranolazine in the management of chronic stable angina." American Journal of Health-System Pharmacy 63, no. 23 (December 1, 2006): 2331–38. http://dx.doi.org/10.2146/ajhp060042.

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