TITLE:
Review of Medical Treatment of Stable Ischemic Heart Disease
AUTHORS:
Abdulelah F. Al Mobeirek, Hanan Albackr, Mostafa Al Shamiri, Turki B. Albacker
KEYWORDS:
Medical Treatment; Stable; Ischemic Heart Disease; Novel Anti-Ischemic Therapy; Anti-Anginal Agents; Coronary Artery Disease
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.5 No.5,
March
21,
2014
ABSTRACT: 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.