Treatment patterns in stable angina: objectives and reality
University Hospital Graz, Graz, Austria
* Correspondence: Werner W. Klein, Medizinische Universitäsklinik, Klinische Abteilung für Kardiologie, Auenbruggerplatz 15, A-8036 Graz, Austria.
Abstract
The aims of treatment for stable angina are to improve symptoms and quality of life, to prevent cardiovascular events and to prolong life. According to current guidelines, such patients require risk factor modification, education and pharmacological treatment with beta-blockers, calcium channel blockers and nitrates, with cardioprotection with aspirin, lipid-lowering drugs and angiotensin-converting enzyme inhibitors. Despite this treatment, approximately one-third of patients do not become free of angina. Various combinations of haemodynamic agents did not demonstrate significant superior efficacy in terms of exercise test parameters. Therefore, there is a strong rationale for using new combined therapeutic approaches, including metabolic drugs such as trimetazidine. As yet, there is no evidence of an effect on the progression of atherosclerotic disease or morbidity or mortality with our treatment approach. A new epidemiological survey (Angina Treatment Pattern Survey) will be carried out in several countries. This survey is designed to characterize the angina patient population to describe current practice, and to evaluate the efficacy and limits of current management.
Key Words: Ischaemia • pharmacotherapy • stable angina • trimetazidine