In the current issue of Cardiovascular Innovations and Applications (Special Issue on Stable Ischemic Heart Disease, Volume 3, Number 3, 2019, pp. 269-278(10); DOI https:/
Angina persists for many patients despite medical therapy and/or revascularization. In all patients with angina, aggressive risk factor modification and optimized medical management must be instituted. Revascularization should be performed for high-risk patients or patients with persistent symptoms. A beta-blocker is likely a first-line agent; how-ever, most patients require multiple medications for symptom control. Novel agents with new mechanisms improve treatment options, including ivabradine (sinus node inhibitor), and late Na+blockade (with a mechanism of action complementary to traditional agents) is beneficial in a broad range of patients unresponsive to current treatment options. Ongoing trials may help better define the role of aggressive medical therapy with or without revascularization.
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