Related Experiment Video

Updated: Jun 17, 2025

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration
07:59

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

Published on: April 4, 2022

1.3K

Optimizing Management of Stable Angina: A Patient-Centered Approach Integrating Revascularization, Medical Therapy,

Rocco A Montone1, Riccardo Rinaldi2, Giampaolo Niccoli3

  • 1Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Journal of the American College of Cardiology
|August 14, 2024
PubMed

Insights

Managing angina requires personalized strategies for both obstructive coronary artery disease (CAD) and ischemia with nonobstructed coronary arteries (INOCA). Tailored therapies targeting specific mechanisms improve patient outcomes.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Clinical Therapeutics

Background:

  • Angina pectoris presents with either obstructive coronary artery disease (CAD) or ischemia with nonobstructed coronary arteries (INOCA).
  • Treatment for obstructive CAD aims to reduce cardiovascular events and symptoms.
  • Management for INOCA focuses on functional coronary circulation alterations.

Purpose of the Study:

  • To review evidence for angina management.
  • To highlight the roles of revascularization, medical therapy, and lifestyle interventions.
  • To emphasize a personalized approach targeting underlying pathobiology.

Main Methods:

  • Expert opinion paper reviewing existing evidence.
  • Analysis of therapeutic strategies for obstructive CAD and INOCA.
  • Discussion of diagnostic and treatment paradigms.

Main Results:

  • Coronary revascularization may improve angina in obstructive CAD, but persistence/recurrence suggests functional mechanisms.
  • Precise endotype diagnosis is crucial for tailored therapy in INOCA.
  • Optimal medical therapy and lifestyle interventions are key components.

Conclusions:

  • A personalized approach is essential for effective angina management.
  • Understanding the specific pathobiology of angina is critical for treatment selection.
  • Integrated strategies combining revascularization, medical therapy, and lifestyle changes offer the best outcomes.

Keywords:
INOCAchronic coronary syndromesischemic heart diseasepersonalized medicinetherapy

More Related Videos

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.0K
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

4.9K

Related Concept Videos

Antianginal Drugs: Nitrates and β-Blockers01:16

Antianginal Drugs: Nitrates and β-Blockers

In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates,  such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow....
550
Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
467
Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
1.2K
Chronic Obstructive Pulmonary Disease-V: Management01:29

Chronic Obstructive Pulmonary Disease-V: Management

Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
2.5K
Peptic Ulcer Disease IV: Management01:26

Peptic Ulcer Disease IV: Management

Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
78
COPD: Management Using Bronchodilators and Corticosteroids01:26

COPD: Management Using Bronchodilators and Corticosteroids

Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
190