title: Treatment of Angina Pectoris Associated with Coronary Microvascular Dysfunction.
abstract: Treatment of angina pectoris associated with coronary microvascular dysfunction is challenging as the underlying mechanisms are often diverse and overlapping. Patients with type 1 coronary microvascular dysfunction (i.e. absence of epicardial coronary artery disease and myocardial disease) should receive strict control of their cardiovascular risk factors and thus receive statins and ACE-inhibitors in most cases. Antianginal medication consists of ß-blockers and/or calcium channel blockers. Second line drugs are ranolazine and nicorandil with limited evidence. Despite individually titrated combinations of these drugs up to 30 % of patients have refractory angina. Rho-kinase inhibitors and endothelin-receptor antagonists represent potential drugs that may prove useful in these patients in the future.
authors.affiliation: Department of Cardiology, Robert-Bosch-Krankenhaus, 110, 70376, Stuttgart, Germany. Peter.Ong@rbk.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Ong
authors.affiliation: Department of Cardiology, Robert-Bosch-Krankenhaus, 110, 70376, Stuttgart, Germany.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Athanasiadis
authors.affiliation: Department of Cardiology, Robert-Bosch-Krankenhaus, 110, 70376, Stuttgart, Germany.
authors.forename: Udo
authors.initials: U
authors.lastname: Sechtem
mesh_terms: D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000503:physiopathology; D006801:Humans; D055806:Microvessels / Q000503:physiopathology
chemical_list: D002317:Cardiovascular Agents
keywords: Angina pectoris; Coronary microvascular dysfunction; Pharmacotherapy