State of the art approach to managing angina and ischemia: tailoring treatment to the evidence

Published:August 18, 2021DOI:


      • No antianginal drug improves survival while they have roughly the same level of evidence on angina relief.
      • A more tailored approach to antianginal treatment may have additional benefits beyond angina relief.
      • Individualizing antianginal drug treatment according the hemodynamic parameters as well as the comorbidities of patients.


      Stable angina represents a chronic and often debilitating condition that affects daily activities and quality of life in patients with chronic coronary syndromes (CCS). Current European Society of Cardiology guidelines recommend a four-step approach for the medical treatment of patients taking into consideration hemodynamic variables (heart rate and blood pressure) and the presence or absence of left ventricular dysfunction. However, CCS patients often have several comorbidities and risk factors. Thus, a tailored approach that takes into consideration patient risk factors and comorbidities may have additional benefits beyond angina relief. This is a state of the art review of stable angina treatment based on the currently available evidence.
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