Treatment for angina
Pro Research Analysisby 
Searched over 200M research papers
Consensus Meter
Treatment for Angina: Current and Emerging Therapies
Introduction to Angina Treatment
Angina pectoris, commonly known as angina, is chest pain caused by myocardial ischemia, typically due to obstructive coronary artery disease. The primary goals in treating stable angina are to alleviate symptoms, improve quality of life, and reduce the risk of adverse cardiovascular events .
Traditional Antianginal Therapies
Beta-Blockers
Beta-blockers are often the first line of treatment for stable angina. They work by reducing heart rate and myocardial oxygen demand, which helps to prevent angina attacks. Beta-blockers are particularly beneficial for patients with a history of myocardial infarction or hypertension. They are effective in reducing the incidence of cardiac events and improving survival rates .
Calcium Channel Blockers
Calcium channel blockers are another cornerstone of angina treatment. They help by dilating blood vessels and reducing the workload on the heart. These drugs are especially useful for patients who cannot tolerate beta-blockers or have contraindications to their use . They are effective in relieving angina and improving exercise tolerance.
Nitrates
Nitrates, such as nitroglycerin, are used for both immediate relief and long-term management of angina. They work by dilating blood vessels, which improves blood flow to the heart muscle. Long-acting nitrates are particularly useful for patients who experience frequent angina attacks .
Emerging Antianginal Therapies
Ranolazine
Ranolazine is a relatively new antianginal medication that works by inhibiting the late phase of the sodium current in the heart, thereby reducing intracellular calcium overload. This mechanism helps to improve myocardial relaxation and reduce angina symptoms. Ranolazine is particularly useful for patients who do not respond adequately to traditional therapies .
Ivabradine
Ivabradine works by selectively inhibiting the If current in the sinoatrial node, leading to a reduction in heart rate without affecting myocardial contractility. This makes it a valuable option for patients who cannot tolerate beta-blockers .
Nicorandil
Nicorandil combines the properties of nitrates and potassium channel activators. It helps to dilate blood vessels and improve blood flow to the heart. Nicorandil is effective in reducing angina symptoms and is often used as an adjunctive therapy .
Trimetazidine
Trimetazidine is a metabolic agent that improves myocardial glucose utilization, thereby enhancing cardiac efficiency. It is particularly useful for patients with refractory angina who do not respond to other treatments .
Non-Pharmacological Therapies
Acupuncture
Recent studies have shown that acupuncture can be an effective adjunctive therapy for chronic stable angina. Acupuncture on disease-affected meridians has been found to significantly reduce the frequency of angina attacks when used alongside traditional antianginal therapies .
Enhanced External Counterpulsation (EECP) and Spinal Cord Stimulation (SCS)
For patients with refractory angina, non-pharmacological options like EECP and SCS have shown promise. These therapies help to improve blood flow and reduce angina symptoms, providing relief for patients who do not respond to conventional treatments.
Conclusion
The treatment of angina involves a combination of lifestyle modifications, pharmacological therapies, and, in some cases, non-pharmacological interventions. Traditional therapies like beta-blockers, calcium channel blockers, and nitrates remain the mainstay of treatment. However, emerging therapies such as ranolazine, ivabradine, and acupuncture offer additional options for patients with refractory angina. A personalized approach, considering the patient's comorbidities and response to treatment, is essential for optimal management of angina.
Sources and full results
Most relevant research papers on this topic