IMR Press / RCM / Volume 10 / Issue S1 / DOI: 10.3909/ricm10S10004

Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on as a courtesy and upon agreement with MedReviews, LLC.

Open Access Review
Evaluating Medical, Percutaneous Coronary Intervention, and Coronary Artery Bypass Surgery Options for Chronic Angina: An Update of the Revised Guidelines
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1 Harvard Medical School, Brigham and Women's Hospital, Boston, MA
2020 University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA
Rev. Cardiovasc. Med. 2009, 10(S1), 21–29;
Published: 20 January 2009

Medical therapy is the standard background treatment for all patients with chronic stable angina. Studies show that antianginal therapies such as late sodium channel blockers (ranolazine), β-blockers, calcium channel blockers, and nitrates dispensed alone or in combination can alleviate angina and angina-equivalent symptoms. For risk reduction of ischemic events, modification of coronary risk factors with lifestyle modification and medical therapy is the cornerstone. Effective risk modification strategies include lipid management, smoking cessation, diabetes control, weight management, nutritional enhancements, and physical activity. The pursuit of a more definitive treatment for chronic angina should be guided by the patient’s clinical presentation, results of imaging-based risk-stratification evaluations, response to medical therapies, and patient preference. Revascularization by percutaneous coronary intervention or coronary artery bypass surgery may be recommended for patients who have persistent and intolerable symptoms despite optimal medical therapy and for those who are likely to have a survival benefit from revascularization based on the severity and location of the atherosclerotic lesions.

Late sodium channel blockers
Lipid management
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