Optimal treatment of stable angina

Angina pectoris due to coronary artery disease is a common manifestation of myocardial ischemia. Reduction of oxygen demand (beta-blockers) and relief of coronary vasoconstriction (calcium blocker or nitrate) are additive approaches to controlling ischemia. Risk factor reduction may improve coronary vascular physiology, and ASA reduces the likelihood of thrombosis and myocardial infarction. It is still unclear whether reduction of angina reduces cardiac morbidity and/or mortality. In the Asymptomatic Cardiac Ischemia Pilot Study (ACIP) and Total Ischemic Burden Bisoprolol Study (TIBBS) trials, data suggest benefit from reducing myocardial ischemia. Thus control of angina pectoris is a major goal of the treatment of coronary artery disease.