Medical management of chronic stable angina

Abstract

SUMMARYStable angina pectoris is characterised by typical exertional chest pain that is relieved by rest or nitrates.Risk stratification of patients is important to define prognosis, to guide medical management and to select patients suitable for revascularisation.Medical treatment aims to relieve angina and prevent cardiovascular events. Beta blockers and calcium channel antagonists are first-line options for treatment. Short-acting nitrates can be used for symptom relief.Low-dose aspirin and statins are prescribed to prevent cardiovascular events. Clinical evaluationThe history, examination, ECG and laboratory tests provide important prognostic information. Increasing age, chronic kidney disease, diabetes, hypertension, current smoking, previous myocardial infarction, hypercholesterolaemia and heart failure are predictive of adverse outcomes. 9 EchocardiographyEchocardiography provides information about left ventricular function, and regional wall motion abnormalities that may be related to infarction or ischaemia. In patients with stable coronary artery disease, left ventricular ejection fraction is the strongest predictor of long-term survival. The 12-year survival of medically treated patients with ejection fractions greater than 50% is 73%, and 54% if the ejection fraction is between 35% and 49%. Survival is only 21% if the ejection fraction is less than 35%.

Sixteen weeks of aerobic training influence spirometry, s-klotho, and hemodynamic responses to sub-maximal exercise testing in obese men with severe obstructive sleep apnea

“…The ability of exercise to reduce the occurrence of angina in clinical populations has been previously noted. 78,79…”

The Most Important Risk Factors Among Angina Patients in Thi-Qar Governorate in Iraq

“…The most common type is stable angina when the heart works harder than usual through some activities like walking and running. It is called effort angina also, it is a classic type of angina since pain subsides in a few minutes after vigour activities, but it returns after the activity resumes [2].…”

Corn silk decoction for blood lipid in patients with angina pectoris: A systematic review and meta‐analysis

“…AP is related to myocardial ischemia by increasing myocardial oxygen demand and reducing diastolic perfusion time, and more than half of the patients with coronary heart disease were suffering from AP (Fihn et al, 2014;Liu, Du, Cong, Jia, & Yang, 2016). Although conventional pharmacotherapy has been widely applied, a substantial proportion of patients still fail to relieve angina-related symptoms completely (Ren et al, 2014;Wee, Burns, & Bett, 2015). Accumulating evidence indicates that dyslipidemia is correlated with atherosclerotic plaque, playing a dominant role in the occurrence and progression of AP.…”