title: Pharmacological approaches of refractory angina.
abstract: Refractory angina refers to a group of patients with stable coronary atherosclerotic disease and angina symptoms, unresponsive to traditional medical management, while considered to be suboptimal candidates for revascularization procedures. Up to 15% of angina patients are considered to have refractory angina and, taking into account the aging population and the improvements in the treatment of stable coronary artery disease, the incidence of this entity is expected to increase. This review describes traditional and novel pharmacotherapies for symptoms relief and for long-term management of refractory angina. Mechanisms of action and relevant clinical trials are discussed and current recommendations from major European and US cardiovascular societies are reported.
authors.affiliation: Cardiovascular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece.
authors.forename: Andreas A
authors.initials: AA
authors.lastname: Giannopoulos
authors.affiliation: First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece.
authors.forename: George D
authors.initials: GD
authors.lastname: Giannoglou
authors.affiliation: Cardiovascular Division, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: ychatzizisis@icloud.com.
authors.forename: Yiannis S
authors.initials: YS
authors.lastname: Chatzizisis
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000503:physiopathology; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D020108:Nicorandil / Q000494:pharmacology / Q000627:therapeutic use; D009566:Nitrates / Q000494:pharmacology / Q000627:therapeutic use; D000069458:Ranolazine / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D002317:Cardiovascular Agents; D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009566:Nitrates; D020108:Nicorandil; D000069458:Ranolazine
keywords: Novel agents; Pharmacotherapy; Refractory angina