Related Experiment Video

Updated: Aug 31, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
06:39

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

The role of triple therapy in patients with chronic stable angina pectoris

M H Crawford

    Circulation
    |June 1, 1987
    PubMed

    Insights

    For chronic stable angina, triple therapy with beta-blockers, calcium channel blockers, and nitrates may benefit select patients. However, vasodilation side effects and patient suitability require careful consideration.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Beta-blockers and calcium-channel blockers are effective monotherapies for chronic stable angina pectoris.
    • Some patients remain symptomatic despite monotherapy and benefit from combined treatments.

    Purpose of the Study:

    • To evaluate the effectiveness and limitations of combined and triple therapy regimens for chronic stable angina.
    • To assess the role of calcium channel blockers and nitrates in managing refractory angina symptoms.

    Main Methods:

    • Review of existing studies on combination therapy (beta-blockers and nitrates, beta-blockers and calcium channel blockers).
    • Analysis of evidence regarding triple therapy (beta-blockers, calcium channel blockers, and nitrates).

    Main Results:

    • Combination therapy with beta-blockers and nitrates or calcium channel blockers offers benefits for symptomatic patients.
    • Triple therapy may provide additional benefit for patients refractory to dual therapy, but vasodilation side effects like orthostatic hypotension are a concern.
    • Limited long-term data exists for calcium blocker-nitrate combinations.

    Conclusions:

    • Triple therapy can be valuable for selected chronic stable angina patients unresponsive to dual therapy.
    • Caution is advised in patients with reduced left ventricular function or conduction system disease due to potential vasodilation side effects and exclusion from studies.

    More Related Videos

    Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

    Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

    Published on: February 3, 2021

    Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration07:59

    Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

    Published on: April 4, 2022

    Related Concept Videos

    Coronary Artery Disease V: Interprofessional Care01:27

    Coronary Artery Disease V: Interprofessional Care

    Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
    Acute Coronary Syndrome IV: Interprofessional Care01:28

    Acute Coronary Syndrome IV: Interprofessional Care

    IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
    Angina IV: Management01:26

    Angina IV: Management

    IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
    Angina V: Nursing Management01:20

    Angina V: Nursing Management

    Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
    Atherosclerosis III: Management01:26

    Atherosclerosis III: Management

    Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
    Peripheral Artery Disease III: Interprofessional Care01:27

    Peripheral Artery Disease III: Interprofessional Care

    Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...