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Nitrates in silent ischemia

H Purcell¹, D Mulcahy, K Fox

¹Royal Brompton Hospital, London, UK.

Cardiovascular Drugs and Therapy

|October 1, 1994

Summary

This summary is machine-generated.

Silent myocardial ischemia, often occurring without chest pain in coronary artery disease patients, is a marker of poor outcomes. While its mechanisms mirror angina, nitrates are not specifically indicated for silent ischemia treatment.

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Area of Science:

Cardiology
Ischemic Heart Disease

Background:

Transient myocardial ischemia episodes occur frequently in coronary artery disease patients without symptoms.
Silent myocardial ischemia is well-documented via ambulatory electrocardiographic monitoring.
These episodes signify true ischemia and are linked to adverse outcomes.

Purpose of the Study:

To review the understanding of silent myocardial ischemia.
To discuss the role of antianginal medications, particularly nitrates, in managing silent ischemia.

Main Methods:

Review of existing literature and clinical evidence on silent myocardial ischemia.
Analysis of the pathophysiology and treatment of myocardial ischemia.

Main Results:

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Silent myocardial ischemia shares pathophysiological mechanisms with angina.

Both silent ischemia and angina respond to antianginal medications.

Long-acting nitrates can prevent myocardial ischemia but require intermittent use with other agents due to tolerance.

Conclusions:

Nitrates are valuable for angina treatment and prevention due to safety and cost-effectiveness.
Current evidence does not support a specific indication for nitrate use in treating silent myocardial ischemia.