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Management of refractory angina pectoris
Aarush Manchanda1, Ashim Aggarwal, Nupur Aggarwal
1Intermountain Valley View Heart Clinic, Cedar City, UT, USA.
Cardiology Journal
|July 20, 2011
Summary
Patients with refractory angina pectoris (RAP) have limited treatment options. This review explores emerging therapies like ranolazine, enhanced external counterpulsation, and neurostimulation for intractable angina symptoms.
Area of Science:
- Cardiology
- Pharmacology
- Interventional Cardiology
Background:
- Despite advances, intractable angina persists in a significant patient population.
- Refractory angina pectoris (RAP) presents ongoing therapeutic challenges.
Purpose of the Study:
- To define refractory angina pectoris (RAP).
- To review current and emerging therapeutic options for patients with RAP.
Main Methods:
- Literature review of pharmacological and non-invasive therapies.
- Examination of invasive treatment modalities for chronic angina.
- Analysis of recent clinical trial data on novel interventions.
Main Results:
- Ranolazine is indicated for chronic angina, often in combination therapy.
- Enhanced external counterpulsation improves symptoms and ventricular function.
- Neurostimulation demonstrates efficacy in reducing angina symptoms.
- Transmyocardial laser revascularization is an established invasive option.
- Investigational therapies include gene therapy and novel revascularization techniques.
Conclusions:
- A range of therapeutic options exist for refractory angina pectoris.
- Novel pharmacological and device-based therapies offer new hope for patients.
- Ongoing research into advanced revascularization and regenerative medicine is crucial.
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