Pharmacological Treatment of Chronic Stable Angina Pectoris

289 Pages·2015·4.109 MB·English

by  Pablo Avanzas, Juan Carlos Kaski (eds.)

Current Cardiovascular Therapy
Series Editor: Juan Carlos Kaski
Pablo Avanzas
Juan Carlos Kaski Editors
Pharmacological
Treatment of
Chronic Stable
Angina Pectoris
Current Cardiovascular
Therapy
Series editor
Juan Carlos Kaski
London , United Kingdom
For further volumes:
http://www.springer.com/series/10472
Cardiovascular pharmacotherapy is a fast-moving and complex
discipline within cardiology in general. New studies, trials and in-
dications are appearing on a regular basis.This series created with
the support of the International Society of Cardiovascular Phar-
macotherapy (ISCP) is designed to establish the baseline level of
knowledge that a cardiovascular professional needs to know on a
day-to-day basis. The information within is designed to allow read-
ers to learn quickly and with certainty the mode of action, the pos-
sible adverse effects, and the management of patients prescribed
these drugs. The emphasis is on current practice, but with an eye
to the near-future direction of treatment.This series of titles will be
presented as highly practical information, written in a quick-access,
no-nonsense format. The emphasis will be on a just-the-facts clini-
cal approach, heavy on tabular material, light on dense prose. The
books in the series will provide both an in-depth view of the science
and pharmacology behind these drugs and a practical guide to their
usage, which is quite unique.Each volume is designed to be be-
tween 120 and 250 pages containing practical illustrations and de-
signed to improve understand and practical usage of cardiovascular
drugs in specifi c clinical areas. The books will be priced to attract
individuals and presented in a softback format. It will be expected
to produce new editions quickly in response to the rapid speed of
development of new CV pharmacologic agents.
Pablo Avanzas (cid:129) Juan Carlos Kaski
Editors

Pharmacological
Treatment of Chronic
Stable Angina Pectoris
Editors
Pablo Avanzas Juan Carlos Kaski
Department of Cardiology Cardiovascular and Cell
Hospital Universitario Central Sciences Research Institute
de Asturias S t George’s University
Oviedo of London
Spain London
UK
Current Cardiovascular Therapy
ISBN 978-3-319-17331-3 ISBN 978-3-319-17332-0 (eBook)
DOI 10.1007/978-3-319-17332-0
Library of Congress Control Number: 2015942523
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Foreword
T he pharmacological treatment of chronic stable angina is a
major clinical challenge. Treatment of stable angina has two
important goals: (1) to improve quality of life and (2) to
improve “quantity” of life. The first aim is achieved by opti-
mal symptom control and the second goal by implementation
of optimal secondary prevention. Interestingly, despite the
obvious importance of treating this condition, the informa-
tion in this field is scattered and there is no convenient refer-
ence book that encompasses both aspects of the management
of stable angina. Therefore, this excellent book is welcome
and fills an important gap.
Pharmacological Treatment of Chronic Stable Angina
Pectoris begins with a clear presentation of the pathophysiol-
ogy of stable angina, highlighting its complexity, which goes
beyond the presence of epicardial coronary artery stenoses.
This is followed by an interesting overview and critical reap-
praisal of both European and North American Guidelines.
The authors then describe the mechanisms of action and the
clinical indications of traditional and of new antianginal drugs.
An interesting chapter is dedicated to antianginal drugs still
not available for clinical use, highlighting innovative thera-
peutic targets. The last chapter offers a balanced view of the
ongoing harsh controversy on medical therapy versus revas-
cularization in the management of stable angina pectoris. It
shows how to interpret current evidence in order to offer each
patient the most appropriate form of treatment.
This remarkable book edited by Pablo Avanzas and Juan
Carlos Kaski is eminently readable, and guides the reader
v
vi Foreword
through the complexities of the field. It will be highly
appreciated by clinical cardiologists and will enhance the
clinical care of patients affected by this important condition.
Rome, Italy Filippo Crea , MD
Contents

1 Mechanisms of Angina Pectoris . . . . . . . . . . . . . . . 1
Gaetano Antonio L anza
2 An Overview of Treatment and Guidelines:
ESC/ACC- AHA/NICE. . . . . . . . . . . . . . . . . . . . . . . 33
Jason M. Tarkin and Juan Carlos Kaski
3 Beta-Blockers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Esteban López-de-Sá and José López-Sendón
4 Calcium Channel Blockers. . . . . . . . . . . . . . . . . . . . 79
Peter Ong and Udo Sechtem
5 Nitrates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Amelia Carro and Pablo Avanzas
6 Nicorandil. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Jason M. Tarkin and Juan Carlos Kaski
7 Ivabradine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Alberto Dominguez-Rodriguez
8 Trimetazidine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Alda Huqi , Giacinta Guarini ,
Doralisa Morrone , and Mario Marzilli
vii
viii Contents
9 Ranolazine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Giuseppe M. C. Rosano , Cristiana Vitale ,
and Maurizio Volterrani
10 New Antianginal Drugs Still Not Available
for Clinical Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Juan Tamargo and Eva Delpón
11 Medical Therapy Versus Revascularization
in the Management of Stable Angina Pectoris . . . 235
Isaac Pascual , Pablo Avanzas , Raquel del Valle ,
and César Morís
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Contributors
Pablo Avanzas , MD, PhD, FESC Cardiac Catheterization
Laboratories , Area del Corazón, Hospital Universitario
Central de Asturias , Oviedo , Spain
Amelia Carro , MD, PhD Department of Cardiology ,
Hospital de Jove , Gijón , Spain
Eva Delpón Department of Pharmacology , School
of Medicine, University Complutense , Madrid , Spain
Raquel del Valle , MD Cardiac Catheterization
Laboratories , Area del Corazón, Hospital Universitario
Central de Asturias , Oviedo , Spain
Alberto Dominguez-Rodriguez , MD, PhD, FESC
Department of Cardiology , Hospital Universitario
de Canarias , Tenerife , Spain
Giacinta G uarini Cardiovascular Medicine Division,
Cardio- Thoracic and Vascular Department , University
of Pisa , Pisa (Pi) , Italy
Alda Huqi Cardiovascular Medicine Division,
Cardio- Thoracic and Vascular Department , University
of Pisa , Pisa (Pi) , Italy
Juan Carlos Kaski, MD, DSc, FRCP, FESC, FACC,
FAHA Cardiovascular and Cell Sciences Research Institute,
St George’s, University of London , London , UK
ix