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Medical Management of Chronic Stable Angina

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Pathophysiology and Pharmacotherapy of Cardiovascular Disease

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Abstract

Chronic stable angina remains an important cause of morbidity in patients with coronary artery disease (CAD). Although dramatic improvements in surgical and percutaneous revascularization techniques have occurred, many patients continue to have symptoms of angina and benefit from pharmacologic therapy. Traditional pharmacologic approaches to angina are reviewed along with novel and more recently introduced therapies. The presence of prior or concurrent conditions such as a prior myocardial infarction and/or significant hypertension plays important roles in the choice of antianginal class. In some patients, symptoms persist, and a second class of agent may be helpful; however, in general, a second agent should only be added once maximally tolerated doses of monotherapy have been utilized. It is emphasized that patients with stable angina, particularly those with preserved left ventricular systolic function, have an excellent prognosis. Those patients who respond well to pharmacologic antianginal therapy often do well without invasive intervention.

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  1. Department of Medicine, Mount Sinai and University Health Network Hospitals, University of Toronto, Toronto, Ontario, Canada

    John D. Parker MD, FRCP (C)

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  1. Center for Drug Evaluation and Research Division of Cardiovascular and Renal Products, US Food and Drug Administration, Silver Spring, Maryland, USA

    Gowraganahalli Jagadeesh

  2. Pharmacology Unit, AIMST University, Bedong, Malaysia

    Pitchai Balakumar

  3. Center for Drug Evaluation and Research Division of Cardiovascular and Renal Products, US Food and Drug Administration, Silver Spring, Maryland, USA

    Khin Maung-U

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Parker, J.D. (2015). Medical Management of Chronic Stable Angina. In: Jagadeesh, G., Balakumar, P., Maung-U, K. (eds) Pathophysiology and Pharmacotherapy of Cardiovascular Disease. Adis, Cham. https://doi.org/10.1007/978-3-319-15961-4_22

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