title: Treatment of refractory angina.
abstract: It is estimated that as many as 1,000,000 people in the United States have chronic symptomatic coronary artery disease (often referred to as refractory angina) that is recalcitrant to medical therapy and unamenable to conventional revascularization procedures. Patients have reproducible lifestyle-limiting symptoms of chest pain, shortness of breath, and easy fatigability. Several new therapies are available to treat this difficult patient population, including newer drugs, enhanced external counterpulsation, transmyocardial revascularization, and cell-based therapies. This article reviews the current state of the art for treatment of refractory angina.
authors: Department of Cardiology, Ochsner Clinic Foundation, New Orleans, LA.
authors: Mark A
authors: MA
authors: Grise
authors: Anil
authors: A
authors: Verma
references: JAMA. 2004 Jan 21;291(3):309-16
references: 14734593
references: J Nucl Med. 2006 Apr;47(4):574-80
references: 16595489
references: JAMA. 1988 Oct 14;260(14):2088-93
references: 2901501
references: Circulation. 2005 Mar 29;111(12):1556-66
references: 15795364
references: Circulation. 2004 Aug 24;110(8):904-10
references: 15302796
references: Semin Thorac Cardiovasc Surg. 1999 Jan;11(1):19-23
references: 9930707
references: J Am Coll Cardiol. 2007 Oct 16;50(16):1523-31
references: 17936150
references: Lancet. 1999 Feb 13;353(9152):519-24
references: 10028979
references: Am J Cardiol. 1997 Aug 1;80(3):331-3
references: 9264427
references: J Am Coll Cardiol. 2001 May;37(6):1726-32
references: 11345391
references: Eur Heart J. 2007 Dec;28(24):2998-3005
references: 17984132
references: Drugs. 1996 May;51(5):792-819
references: 8861548
references: Pharmacol Res. 2006 May;53(5):399-406
references: 16638640
references: J Am Coll Cardiol. 1999 Jun;33(7):1833-40
references: 10362181
references: J Am Coll Cardiol. 2004 Jun 2;43(11):2142-6
references: 15172426
references: Am J Cardiol. 2006 Mar 15;97(6):823-9
references: 16516583
references: Lancet. 2002 Apr 13;359(9314):1269-75
references: 11965271
references: Circulation. 1997 Jan 21;95(2):371-5
references: 9008451
references: Lancet. 1991 Oct 26;338(8774):1036-9
references: 1681355
references: J Am Coll Cardiol. 2004 Apr 21;43(8):1375-82
references: 15093870
references: J Am Coll Cardiol. 1999 Jun;33(7):2092-197
references: 10362225
references: Am Heart J. 2006 Mar;151(3):674-80
references: 16504630
references: Eur Heart J. 1988 Feb;9(2):149-58
references: 3280317
references: JAMA. 2009 May 20;301(19):1997-2004
references: 19454638
references: N Engl J Med. 1996 May 23;334(21):1349-55
references: 8614419
references: Mayo Clin Proc. 2007 May;82(5):539-42
references: 17493417
references: N Engl J Med. 1999 Sep 30;341(14):1029-36
references: 10502592
references: Lancet. 1996 Nov 16;348(9038):1329-39
references: 8918275
references: Circulation. 2005 Jan 18;111(2):150-6
references: 15642764
references: Circulation. 1990 May;81(5):1721-33
references: 2184951
references: Eur Heart J. 2005 Dec;26(23):2529-36
references: 16214830
references: Am Heart J. 1985 Jul;110(1 Pt 2):238-45
references: 4013998
references: Heart Surg Forum. 2004 Apr 01;7(2):E130-1
references: 15138089
references: Ann Thorac Surg. 2004 Apr;77(4):1228-34
references: 15063241
references: Circulation. 1996 Jul 15;94(2):130-4
references: 8674170
references: BMJ. 2002 Jan 12;324(7329):71-86
references: 11786451
references: Eur Heart J. 2004 Apr;25(8):634-41
references: 15084367
references: Cochrane Database Syst Rev. 2005 Oct 19;(4):CD003614
references: 16235330
references: Drugs. 2000 Oct;60(4):955-74
references: 11085202
references: N Engl J Med. 1980 Jun 5;302(23):1269-73
references: 6767986
references: J Am Coll Cardiol. 2000 Apr;35(5):1170-7
references: 10758957
references: Lancet. 1999 Sep 11;354(9182):885-90
references: 10489946
references: Eur Heart J. 2009 Mar;30(5):540-8
references: 19136486
references: J Microsurg. 1981 Jun;2(4):253-60
references: 7310316
references: J Cardiovasc Pharmacol. 1986;8 Suppl 4:S135-7
references: 2427844
references: N Engl J Med. 1999 Sep 30;341(14):1021-8
references: 10502591
references: Circulation. 2003 Feb 18;107(6):817-23
references: 12591750
references: N Engl J Med. 1983 Aug 18;309(7):396-403
references: 6135989
references: J Am Coll Cardiol. 2001 Jan;37(1):93-9
references: 11153780
references: J Am Coll Cardiol. 1996 Feb;27(2):311-6
references: 8557899
references: Heart. 2006 Jul;92 Suppl 4:iv6-iv14
references: 16775092
references: Ann Intern Med. 1991 May 15;114(10):835-9
references: 2014943
references: Lancet. 1998 Jun 20;351(9119):1826-7
references: 9652659
references: Eur Heart J. 1993 Oct;14(10):1369-74
references: 8262084
references: Circulation. 1996 Jan 1;93(1):135-42
references: 8616920
references: Lancet. 2003 Jan 4;361(9351):47-9
references: 12517468
references: Mayo Clin Proc. 2004 Oct;79(10):1284-92
references: 15473411
references: Chest. 2004 Sep;126(3 Suppl):234S-264S
references: 15383474
references: JAMA. 2007 Apr 25;297(16):1775-83
references: 17456819