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Management of Refractory Angina Pectoris

Kevin Cheng1,2, Paul Sainsbury3, Michael Fisher4

  • 1Specialist Angina Service, Royal Brompton and Harefield NHS Foundation Trust, London, UK.

European Cardiology
|October 13, 2018
PubMed

Insights

Refractory angina (RA) is a growing challenge in coronary artery disease (CAD) management. This review explores current and novel therapies for RA patients, focusing on improving quality of life.

Area of Science:

  • Cardiology
  • Clinical Medicine

Background:

  • Refractory angina (RA) is increasingly prevalent due to improved survival from coronary artery disease (CAD) and an aging population.
  • RA patients suffer from chronic, uncontrolled angina-type pain despite optimal treatments, significantly impairing quality of life.
  • These patients exhibit high healthcare service utilization, highlighting unmet clinical needs.

Purpose of the Study:

  • To review existing therapies for refractory angina (RA).
  • To discuss novel treatment strategies for RA management.
  • To emphasize the multifactorial needs of RA patients and the role of specialist units.

Main Methods:

  • Literature review of current and emerging therapies for refractory angina.
  • Analysis of clinical challenges and patient outcomes in RA.
  • Discussion of multidisciplinary care models for RA.

Main Results:

  • Optimal pharmacological, interventional, and surgical therapies are often insufficient for RA symptom control.
  • RA significantly impacts patient quality of life, despite comparable mortality rates to other CAD cohorts.
  • Multidisciplinary specialist units are recognized as the optimal setting for managing RA patients.

Conclusions:

  • Refractory angina presents a significant clinical challenge requiring comprehensive management strategies.
  • Novel therapeutic approaches hold promise for improving outcomes in RA patients.
  • Addressing the multifactorial needs of RA patients through specialized care is crucial.

Keywords:
Angina pectorischest paincoronary sinus reducerexternal enhanced counterpulsationmyocardial ischaemianeurological manifestationspragmatic rehabilitationrefractory angina pectorisspecialist angina servicesspinal cord stimulation

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