title: [New agents for the therapy of angina pectoris].
abstract: There is a renaissance of medical treatment of chronic angina pectoris despite of advances in interventional therapy. New drugs include nicorandil, ivabradine and ranolazine. Nicorandil dilates venous and arterial vessels via relaxation of smooth muscle cells. Since the drug has only recently been approved, the German experience is limited. Ivabradine exerts an anti-anginous effect by selective action on the sinus node with reduction of heart rate. Multiple studies have demonstrated its anti-anginal efficacy, which has also been shown if it was used as an additional therapy to classic anti-anginal treatment. Its use is reasonable as a substitute for beta-blockers or as an "add-on therapy" combined with beta-blockers, if the target heart rate for treatment of angina pectoris has not been reached. Ranolazine delays the late sodium current into the myocytes. Thereby, it improves the diastolic ventricular function and the microcirculation of the myocardium. Several large studies confirmed the anti-anginal efficacy of the drug. Currently it is used if angina pectoris still occurs under a combined treatment with different classic anti-anginal drugs.
authors.affiliation: Klinik für Allgemeine und Interventionelle Kardiologie, Universitäres Herzzentrum, Martinistraße 52, 20246, Hamburg. meinertz@uke.de
authors.forename: T
authors.initials: T
authors.lastname: Meinertz
authors.forename: R
authors.initials: R
authors.lastname: Köster
mesh_terms: D000083:Acetanilides / Q000009:adverse effects / Q000627:therapeutic use*; D000787:Angina Pectoris / Q000188:drug therapy*; D001552:Benzazepines / Q000009:adverse effects / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000188:drug therapy*; D054815:Cyclic Nucleotide-Gated Cation Channels / Q000187:drug effects*; D004311:Double-Blind Method; D017277:Drug Approval; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D000077550:Ivabradine; D020108:Nicorandil / Q000009:adverse effects / Q000627:therapeutic use*; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000069458:Ranolazine; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000083:Acetanilides; D001552:Benzazepines; D054815:Cyclic Nucleotide-Gated Cation Channels; D004791:Enzyme Inhibitors; D010879:Piperazines; D014665:Vasodilator Agents; D020108:Nicorandil; D000077550:Ivabradine; D000069458:Ranolazine