Pharmacotherapy of Vasospastic Angina

Harris, Justin; Hale, Genevieve M; Dasari, Tarun W.; Schwier, Nicholas C.

doi:10.1177/1074248416640161

Cited by 28 publications

(23 citation statements)

References 78 publications

(157 reference statements)

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“…Dihydropyridines can be added to medical regimens of patients who continue to experience angina symptoms despite the maximally tolerated dose of BB. CCBs are considered the agents of choice in patients with vasospastic angina [59]. …”

Section: Management Of Anginamentioning

confidence: 99%

Advancements in pharmacotherapy for angina

Jain

Elgendy

Al‐Ani

et al. 2017

Expert Opinion on Pharmacotherapy

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Introduction Angina pectoris is the most prevalent symptomatic manifestation of ischemic heart disease, frequently leads to a poor quality of life, and is a major cause of medical resource consumption. Since the early descriptions of nitrite and nitrate in the 19th century, there has been considerable advancement in the pharmacologic management of angina. Areas covered Management of chronic angina is often challenging for clinicians. Despite introduction of several pharmacological agents in last few decades, a significant proportion of patients continue to experience symptoms (i.e., refractory angina) with subsequent disability. For the purpose of this review, we searched PubMed and Cochrane databases from inception to August 2016 for the most clinically relevant publications that guide current practice in angina therapy and its development. In this article, we briefly review the pathophysiology of angina and mechanism-based classification of current therapy. This is followed by evidence-based insight into the traditional and novel pharmacotherapeutic agents, highlighting their clinical usefulness. Expert opinion Considering the wide array of available therapies with different mechanism efficacy and limiting factors, a personalized approach is essential, particularly for patients with refractory angina. Ongoing research with novel pharmacologic modalities is likely to provide new options for management of angina.

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Section: Management Of Anginamentioning

confidence: 99%

Advancements in pharmacotherapy for angina

Jain

Elgendy

Al‐Ani

et al. 2017

Expert Opinion on Pharmacotherapy

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“…The clinical feature is dominated by rest angina, preserved effort tolerance and ST segment elevation in the ECG. In general, vasospastic angina responds to CCBs 193, 194. A meta-analysis evaluating the efficacy of CCBs (amlodipine, nifedipine, benidipine and diltiazem) on vasospastic angina revealed that benidipine showed a statistically significant reduction in major cardiovascular events than amlodipine, nifedipine or diltiazem 194 .…”

Section: Treatment Of Certain Forms Of Stable Cadmentioning

confidence: 99%

“…A meta-analysis evaluating the efficacy of CCBs (amlodipine, nifedipine, benidipine and diltiazem) on vasospastic angina revealed that benidipine showed a statistically significant reduction in major cardiovascular events than amlodipine, nifedipine or diltiazem 194 . Further, long-acting nitrates can also improve the efficacy of treatment and should be scheduled to cover the period of the day in which ischaemic episodes most frequently occur, to prevent nitrate tolerance 193 . Beta-blockers should be avoided, to prevent probable spasm 193 .…”

Section: Treatment Of Certain Forms Of Stable Cadmentioning

confidence: 99%

“…Further, long-acting nitrates can also improve the efficacy of treatment and should be scheduled to cover the period of the day in which ischaemic episodes most frequently occur, to prevent nitrate tolerance 193 . Beta-blockers should be avoided, to prevent probable spasm 193 . Furthermore, in refractive attacks of vasospastic angina, anti-alpha-adrenergic drugs, such as guanethidine or clonidine, may be helpful 195 …”

Section: Treatment Of Certain Forms Of Stable Cadmentioning

confidence: 99%

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Management standards for stable coronary artery disease in India

Mishra

Ray

Dalal

et al. 2016

Indian Heart Journal

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Coronary artery disease (CAD) is one of the important causes of cardiovascular morbidity and mortality globally, giving rise to more than 7 million deaths annually. An increasing burden of CAD in India is a major cause of concern with angina being the leading manifestation. Stable coronary artery disease (SCAD) is characterised by episodes of transient central chest pain (angina pectoris), often triggered by exercise, emotion or other forms of stress, generally triggered by a reversible mismatch between myocardial oxygen demand and supply resulting in myocardial ischemia or hypoxia. A stabilised, frequently asymptomatic phase following an acute coronary syndrome (ACS) is also classified as SCAD. This definition of SCAD also encompasses vasospastic and microvascular angina under the common umbrella.

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“…It combines visceral pericardial constriction with pericardial inflammation. Variant angina was described by Prinzmetal and it consists of chest pain at rest, ST-elevation, and spontaneous resolution or resolution with the use of sublingual nitroglycerin [4]. The reported underlying mechanisms are autonomic nervous system, inflammation, endothelial dysfunction, smooth muscle cell hypercontractility, oxidative stress and genetics [5].…”

Section: Introductionmentioning

confidence: 99%

Idiopathic Effusive-Constrictive Pericarditis Presented by Variant Angina

Adachi

Hayashi

Omatsu

et al. 2021

Cureus

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An 80-year-old man presented to our hospital complaining of loss of appetite. During the medical examination, he developed variant angina accompanied with heart failure. Oral calcium channel blocker therapy controlled his variant angina, but medical management of heart failure became increasingly difficult due to gradually increasing pericardial effusion, and pericardiocentesis leading to the diagnosis of effusive-constrictive pericarditis (ECP). Here, we report a rare case of idiopathic pericarditis caused variant angina with already having endothelial dysfunction and eventually developed ECP.

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Pharmacotherapy of Vasospastic Angina

Cited by 28 publications

References 78 publications

Advancements in pharmacotherapy for angina

Advancements in pharmacotherapy for angina

Management standards for stable coronary artery disease in India

Idiopathic Effusive-Constrictive Pericarditis Presented by Variant Angina

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