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Overview of Management of Myocardial Ischemia: a Mechanistic-Based Approach

Gaetano Antonio Lanza1, Filippo Crea2

  • 1Institute of Cardiology, Università Cattolice del Sacro Cuore, Policlinico A. Gemelli, Largo A. Gemelli, 8, 00168, Roma, Italy. gaetanoantonio.lanza@unicatt.it.

Cardiovascular Drugs and Therapy
|April 20, 2016
PubMed

Insights

Standard heart medications manage chronic stable angina (CSA) symptoms. Novel drugs like ranolazine offer additional anti-ischemic benefits, but their impact on long-term prognosis in CSA remains under investigation.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Chronic stable angina (CSA) is primarily managed with heart rate lowering and vasodilator drugs.
  • Alternative pharmacologic agents with unique mechanisms, such as ranolazine and trimetazidine, offer potential anti-ischemic and anti-anginal effects.

Purpose of the Study:

  • To review the role of standard and novel pharmacologic treatments for myocardial ischemia in CSA.
  • To discuss the current understanding of the prognostic implications of myocardial ischemia in CSA and the impact of its suppression on clinical outcomes.

Main Methods:

  • Literature review of existing studies on pharmacologic treatments for CSA.
  • Analysis of the mechanisms of action for standard and novel anti-ischemic agents.
  • Discussion of clinical trial data and observational studies regarding prognosis in CSA.

Main Results:

  • Standard therapies effectively control angina symptoms and improve quality of life.
  • Novel agents like ranolazine and trimetazidine provide supplementary anti-ischemic benefits.
  • The prognostic significance of myocardial ischemia and the benefit of its complete suppression in CSA are not definitively established.

Conclusions:

  • While current treatments manage symptoms, the long-term prognostic impact of myocardial ischemia in CSA requires further investigation.
  • Novel anti-ischemic drugs may offer adjunctive benefits, but their role in altering the natural course of CSA is still debated.

Keywords:
AnginaClinical outcomeMedical therapyMyocardial ischemiaPathophysiologic mechanisms

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