title: Emerging therapies for refractory angina.
abstract: In recent years, improvements in both pharmacologic and revascularization therapies have greatly increased life expectancy for patients with coronary artery disease (CAD). As patients with more extensive CAD live longer, many develop myocardial ischemia and clinical angina that is not amenable to traditional revascularization therapy. Patients with severe, symptomatic, chronic CAD have been described as having refractory angina; they have also been termed "no-option" patients. This article discusses clinical management of this unique and growing group of patients and emerging therapeutic options including pharmacologic agents, enhanced external counterpulsation therapy, therapeutic angiogenesis, neurostimulation, and transmyocardial revascularization.
authors.affiliation: Division of Cardiovascular Disease, Minneapolis Heart Institute Foundation/Abbott Northwestern Hospital, University of Minnesota, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Satran
authors.forename: Jay H
authors.initials: JH
authors.lastname: Traverse
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Barsness
authors.forename: Amir
authors.initials: A
authors.lastname: Lerman
authors.forename: Robert D
authors.initials: RD
authors.lastname: Simari
authors.forename: Anil K
authors.initials: AK
authors.lastname: Poulose
authors.forename: Randall K
authors.initials: RK
authors.lastname: Johnson
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Henry
mesh_terms: D000787:Angina Pectoris / Q000401:mortality / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000401:mortality / Q000628:therapy*; D015908:Counterpulsation; D005260:Female; D005544:Forecasting; D006801:Humans; D008875:Middle Aged; D008910:Minnesota; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D012106:Research / Q000639:trends; D015607:Stents; D015996:Survival Rate