Review of Medical Treatment of Stable Ischemic Heart Disease

• 作者: Abdulelah F. Al Mobeirek Hanan Albackr Mostafa Al Shamiri Turki B. Albacker
• 来源期刊: 临床医学国际期刊(英文)
• 学科: 医学
• 关键词: Medical Treatment Stable ISCHEMIC Heart DISEASE Novel Anti-Ischemic Therapy Anti-Anginal Agents CORONARY Artery DISEASE
• 年，卷（期）: 2014,（5）
• 页码范围: 249-259
• 页数: 11页
• 分类号: R5

摘要

Medical treatment is the initial treatment strategy and is the cornerstone of management in patients with stable ischemic heart disease (IHD). Many patients are not suitable for percutaneous or surgical revascularization because of unfavourable anatomy, or the presence of co-morbidities. In addition, many patients have recurrence of angina following revascularization due to restenosis or incomplete revascularization. Furthermore, randomized clinical trials comparing optimal medical treatment to revascularization have not clearly shown that myocardial revascularization is superior to optimal medical treatment. Traditional drugs for angina treatment include b-blockers, calcium channel blockers and nitrates. Newer drugs are available with different mechanisms of action and with equal efficacy that do not cause significant hemodynamic deterioration. The availability of these newer drugs expands the therapeutic potential of medical treatment to even a wider population with stable IHD. Revascularization in patients with stable ischemic heart disease has never been shown to reduce hard endpoints (death or myocardial infarction) in randomized clinical trials.