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18.04.2016 | ORIGINAL ARTICLE

Overview of Management of Myocardial Ischemia: a Mechanistic-Based Approach

verfasst von: Gaetano Antonio Lanza, Filippo Crea

Erschienen in: Cardiovascular Drugs and Therapy | Ausgabe 4/2016

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Abstract

Pharmacologic treatment of myocardial ischemia in patients with chronic stable angina (CSA) is mainly based on heart rate lowering drugs and vasodilator agents. Other drugs are available, however, that act by some peculiar mechanism (ranolazine, trimetazidine) and may add potential anti-ischemic and anti-anginal effects to standard therapeutic mechanisms. While anti-ischemic agents are crucial for controlling angina symptoms and improving quality of life, whether myocardial ischemia portends an ominous prognosis and its suppression improves clinical outcome in CSA patients remain debated issues.
Literatur
1.
Zurück zum Zitat Klocke FJ. Measurements of coronary blood flow and degree of stenosis: current clinical implications and continuing uncertainties. J Am Coll Cardiol. 1983;1:31–41.CrossRefPubMed Klocke FJ. Measurements of coronary blood flow and degree of stenosis: current clinical implications and continuing uncertainties. J Am Coll Cardiol. 1983;1:31–41.CrossRefPubMed
2.
Zurück zum Zitat Di Carli M, Czernin J, Hoh CK, et al. Relation among stenosis severity, myocardial blood flow, and flow reserve in patients with coronary artery disease. Circulation. 1995;91:1944–51.CrossRefPubMed Di Carli M, Czernin J, Hoh CK, et al. Relation among stenosis severity, myocardial blood flow, and flow reserve in patients with coronary artery disease. Circulation. 1995;91:1944–51.CrossRefPubMed
3.
Zurück zum Zitat JM JC. Coronary pressure-function and steady-state pressure-flow relations during autoregulation in the unanesthetized dog. Circ Res. 1988;63:821–36.CrossRef JM JC. Coronary pressure-function and steady-state pressure-flow relations during autoregulation in the unanesthetized dog. Circ Res. 1988;63:821–36.CrossRef
4.
Zurück zum Zitat Tousoulis D, Crake T, Kaski JC, et al. Enhanced vasomotor responses of complex coronary stenoses to acetylcholine in stable angina pectoris. Am J Cardiol. 1995;75:725–8.CrossRefPubMed Tousoulis D, Crake T, Kaski JC, et al. Enhanced vasomotor responses of complex coronary stenoses to acetylcholine in stable angina pectoris. Am J Cardiol. 1995;75:725–8.CrossRefPubMed
5.
Zurück zum Zitat Panza JA, Epstein SE, Quyyumi AA. Circadian variation in vascular tone and its relation to alpha-sympathetic vasoconstrictor activity. N Engl J Med. 1991;325:986–90.CrossRefPubMed Panza JA, Epstein SE, Quyyumi AA. Circadian variation in vascular tone and its relation to alpha-sympathetic vasoconstrictor activity. N Engl J Med. 1991;325:986–90.CrossRefPubMed
6.
Zurück zum Zitat Sambuceti G, Marzilli M, Fedele S, Marini C, L'Abbate A. Paradoxical increase in microvascular resistance during tachycardia downstream from a severe stenosis in patients with coronary artery disease: reversal by angioplasty. Circulation. 2001;103:2352–60.CrossRefPubMed Sambuceti G, Marzilli M, Fedele S, Marini C, L'Abbate A. Paradoxical increase in microvascular resistance during tachycardia downstream from a severe stenosis in patients with coronary artery disease: reversal by angioplasty. Circulation. 2001;103:2352–60.CrossRefPubMed
7.
Zurück zum Zitat Pupita G, Maseri A, Kaski JC, et al. Myocardial ischemia caused by distal coronary-artery constriction in stable angina pectoris. N Engl J Med. 1990;323:514–20.CrossRefPubMed Pupita G, Maseri A, Kaski JC, et al. Myocardial ischemia caused by distal coronary-artery constriction in stable angina pectoris. N Engl J Med. 1990;323:514–20.CrossRefPubMed
8.
Zurück zum Zitat Hamasaki S, Arima S, Fukumoto N, et al. Mechanisms of limited maximum coronary flow in severe single-vessel coronary artery disease in humans due to vertical steal. Am J Cardiol. 1997;80:1597–601.CrossRefPubMed Hamasaki S, Arima S, Fukumoto N, et al. Mechanisms of limited maximum coronary flow in severe single-vessel coronary artery disease in humans due to vertical steal. Am J Cardiol. 1997;80:1597–601.CrossRefPubMed
9.
Zurück zum Zitat Holmvang G, Fry S, Skopicki HA, Abraham SA, et al. Relation between coronary "steal" and contractile function at rest in collateral-dependent myocardium of humans with ischemic heart disease. Circulation. 1999;99:2510–6.CrossRefPubMed Holmvang G, Fry S, Skopicki HA, Abraham SA, et al. Relation between coronary "steal" and contractile function at rest in collateral-dependent myocardium of humans with ischemic heart disease. Circulation. 1999;99:2510–6.CrossRefPubMed
10.
Zurück zum Zitat Lalonde F, Poirier P, Sylvestre MP, Arvisais D, Curnier D. Exercise-induced ischemic preconditioning and the potential application to cardiac rehabilitation: a systematic review. Eur J Prev Cardiol. 2015;22:100–12.CrossRefPubMed Lalonde F, Poirier P, Sylvestre MP, Arvisais D, Curnier D. Exercise-induced ischemic preconditioning and the potential application to cardiac rehabilitation: a systematic review. Eur J Prev Cardiol. 2015;22:100–12.CrossRefPubMed
11.
Zurück zum Zitat Matsuzaki M, Patritti J, Tajimi T, Miller M, Kemper WS, Ross J. Effects of beta-blockade on regional myocardial flow and function during exercise. Am J Phys. 1984;247(1 Pt 2):H52–60. Matsuzaki M, Patritti J, Tajimi T, Miller M, Kemper WS, Ross J. Effects of beta-blockade on regional myocardial flow and function during exercise. Am J Phys. 1984;247(1 Pt 2):H52–60.
12.
Zurück zum Zitat Guth BD, Heusch G, Seitelberger R, Matsuzaki M, Ross J Jr. Role of heart rate reduction in the treatment of exercise-induced myocardial ischaemia. Eur Heart J. 1987; 8(Suppl L):61–8. Guth BD, Heusch G, Seitelberger R, Matsuzaki M, Ross J Jr. Role of heart rate reduction in the treatment of exercise-induced myocardial ischaemia. Eur Heart J. 1987; 8(Suppl L):61–8.
13.
Zurück zum Zitat Pepine CJ, Hill JA, Imperi GA, Norvell N. Beta-adrenergic blockers in silent myocardial ischemia. Am J Cardiol. 1988;61:18B–21B.CrossRefPubMed Pepine CJ, Hill JA, Imperi GA, Norvell N. Beta-adrenergic blockers in silent myocardial ischemia. Am J Cardiol. 1988;61:18B–21B.CrossRefPubMed
14.
Zurück zum Zitat Hjalmarson A, Elmfeldt D, Herlitz J, et al. Effect on mortality of metoprolol in acute myocardial infarction. A double-blind randomised trial. Lancet. 1981;2:823–7.CrossRefPubMed Hjalmarson A, Elmfeldt D, Herlitz J, et al. Effect on mortality of metoprolol in acute myocardial infarction. A double-blind randomised trial. Lancet. 1981;2:823–7.CrossRefPubMed
15.
Zurück zum Zitat Pedersen T. The Norwegian multicenter study on timolol after myocardial infarction - design, management and results on mortality. Acta Med Scand (Suppl). 1981;651:235–41. Pedersen T. The Norwegian multicenter study on timolol after myocardial infarction - design, management and results on mortality. Acta Med Scand (Suppl). 1981;651:235–41.
16.
Zurück zum Zitat Pepine CJ, Cohn PF, Deedwania PC, et al. Circulation. effects of treatment on outcome in mildly symptomatic patients with ischemia during daily life. the atenolol silent ischemia study (ASIST). Circulation. 1994;90:762–8.CrossRefPubMed Pepine CJ, Cohn PF, Deedwania PC, et al. Circulation. effects of treatment on outcome in mildly symptomatic patients with ischemia during daily life. the atenolol silent ischemia study (ASIST). Circulation. 1994;90:762–8.CrossRefPubMed
17.
Zurück zum Zitat DAVIT study group. Effect of verapamil on mortality and major events after acute myocardial infarction (the Danish verapamil infarction trial II–DAVIT II). Am J Cardiol. 1990;66:779–85.CrossRef DAVIT study group. Effect of verapamil on mortality and major events after acute myocardial infarction (the Danish verapamil infarction trial II–DAVIT II). Am J Cardiol. 1990;66:779–85.CrossRef
18.
Zurück zum Zitat The Multicenter Diltiazem Postinfarction Trial Research Group. The effect of diltiazem on mortality and reinfarction after myocardial infarction. N Engl J Med. 1988;319:385–92.CrossRef The Multicenter Diltiazem Postinfarction Trial Research Group. The effect of diltiazem on mortality and reinfarction after myocardial infarction. N Engl J Med. 1988;319:385–92.CrossRef
19.
Zurück zum Zitat Boden WE, van Gilst WH, Scheldewaert RG, et al. Diltiazem in acute myocardial infarction treated with thrombolytic agents: a randomised placebo-controlled trial. incomplete infarction trial of European Research Collaborators Evaluating prognosis post-Thrombolysis (INTERCEPT). Lancet. 2000;355:1751–6.CrossRefPubMed Boden WE, van Gilst WH, Scheldewaert RG, et al. Diltiazem in acute myocardial infarction treated with thrombolytic agents: a randomised placebo-controlled trial. incomplete infarction trial of European Research Collaborators Evaluating prognosis post-Thrombolysis (INTERCEPT). Lancet. 2000;355:1751–6.CrossRefPubMed
20.
Zurück zum Zitat Arnman K, Rydén L. Comparison of metoprolol and verapamil in the treatment of angina pectoris. Am J Cardiol. 1982;49:821–7.CrossRefPubMed Arnman K, Rydén L. Comparison of metoprolol and verapamil in the treatment of angina pectoris. Am J Cardiol. 1982;49:821–7.CrossRefPubMed
21.
Zurück zum Zitat Brouwer J, Viersma JW, van Veldhuisen DJ, et al. Efficacy of metoprolol and diltiazem in treating silent myocardial ischemia. Am J Cardiol. 1995;76:759–63.CrossRefPubMed Brouwer J, Viersma JW, van Veldhuisen DJ, et al. Efficacy of metoprolol and diltiazem in treating silent myocardial ischemia. Am J Cardiol. 1995;76:759–63.CrossRefPubMed
22.
Zurück zum Zitat Rehnqvist N, Hjemdahl P, Billing E, et al. Effects of metoprolol versus verapamil treatment in patients with stable angina pectoris-the angina prognosis study In Stockholm (APSIS). Eur Heart J. 1996;17:76–81.CrossRefPubMed Rehnqvist N, Hjemdahl P, Billing E, et al. Effects of metoprolol versus verapamil treatment in patients with stable angina pectoris-the angina prognosis study In Stockholm (APSIS). Eur Heart J. 1996;17:76–81.CrossRefPubMed
23.
Zurück zum Zitat Heidenreich PA, McDonald KM, Hastie T, et al. Meta-analysis oftrials comparing beta-blockers, calcium antagonists, and nitrates for stable angina. JAMA. 1999;281:1927–36.CrossRefPubMed Heidenreich PA, McDonald KM, Hastie T, et al. Meta-analysis oftrials comparing beta-blockers, calcium antagonists, and nitrates for stable angina. JAMA. 1999;281:1927–36.CrossRefPubMed
24.
Zurück zum Zitat Di Francesco D. I (f) inhibition: a novel mechanism of action. Eur Heart J. 2003;5(suppl G):G19–25. Di Francesco D. I (f) inhibition: a novel mechanism of action. Eur Heart J. 2003;5(suppl G):G19–25.
25.
Zurück zum Zitat Borer JS, Fox K, Jaillon P, Lerebours G, Group II. Antianginal and antiischemic effects of ivabradine, an I(f) inhibitor, in stable angina: a randomized, double-blind, multicentered, placebo-controlled trial. Circulation. 2003;107:817–23.CrossRefPubMed Borer JS, Fox K, Jaillon P, Lerebours G, Group II. Antianginal and antiischemic effects of ivabradine, an I(f) inhibitor, in stable angina: a randomized, double-blind, multicentered, placebo-controlled trial. Circulation. 2003;107:817–23.CrossRefPubMed
26.
Zurück zum Zitat Tardif JC, Ford I, Tendera M, Bourassa MG, Fox K, Investigators INITIATIVE. Efficacy of ivabradine, a new selective I(f) inhibitor, compared with atenolol in patients with chronic stable angina. Eur Heart J. 2005;26:2529–36.CrossRefPubMed Tardif JC, Ford I, Tendera M, Bourassa MG, Fox K, Investigators INITIATIVE. Efficacy of ivabradine, a new selective I(f) inhibitor, compared with atenolol in patients with chronic stable angina. Eur Heart J. 2005;26:2529–36.CrossRefPubMed
27.
Zurück zum Zitat Tardif JC, Ponikowski P, Kahan T, Study Investigators ASSOCIATE. Efficacy of the I(f) current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial. Eur Heart J. 2009;30:540–8.CrossRefPubMedPubMedCentral Tardif JC, Ponikowski P, Kahan T, Study Investigators ASSOCIATE. Efficacy of the I(f) current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial. Eur Heart J. 2009;30:540–8.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Fox K, Ford I, Steg PG, Tendera M, Robertson M, Ferrari R. Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet. 2008;372:817–21.CrossRefPubMed Fox K, Ford I, Steg PG, Tendera M, Robertson M, Ferrari R. Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet. 2008;372:817–21.CrossRefPubMed
29.
Zurück zum Zitat Fox K, Ford I, Steg PG, Tardif JC, Tendera M, Ferrari R, Investigators SIGNIFY. Ivabradine in stable coronary artery disease without clinical heart failure. N Engl J Med. 2014;371:1091–9.CrossRefPubMed Fox K, Ford I, Steg PG, Tardif JC, Tendera M, Ferrari R, Investigators SIGNIFY. Ivabradine in stable coronary artery disease without clinical heart failure. N Engl J Med. 2014;371:1091–9.CrossRefPubMed
30.
Zurück zum Zitat Dargie HJ, Ford I, Fox KM, on behalf of the TIBET Study Group. Total lschaemic burden European trial (TIBET): effects of ischaemia and treatment with atenolol, nifedipine SR and their combination on outcome. Eur Hean J. 1996;17:104–12.CrossRef Dargie HJ, Ford I, Fox KM, on behalf of the TIBET Study Group. Total lschaemic burden European trial (TIBET): effects of ischaemia and treatment with atenolol, nifedipine SR and their combination on outcome. Eur Hean J. 1996;17:104–12.CrossRef
31.
Zurück zum Zitat Savonitto S, Ardissiono D, Egstrup K, et al. Combination therapy with metoprolol and nifedipine versus monotherapy in patients with stable angina pectoris. results of the International multicenter angina exercise (IMAGE) study. J Am Coll Cardiol. 1996;27:311–6.CrossRefPubMed Savonitto S, Ardissiono D, Egstrup K, et al. Combination therapy with metoprolol and nifedipine versus monotherapy in patients with stable angina pectoris. results of the International multicenter angina exercise (IMAGE) study. J Am Coll Cardiol. 1996;27:311–6.CrossRefPubMed
32.
Zurück zum Zitat von Arnim T. Medical treatment to reduce total ischemic burden: total ischemic burden bisoprolol study (TIBBS), a multicenter trial comparing bisoprolol and nifedipine. the TIBBS Investigators. J Am Coll Cardiol. 1995;25:231–8.CrossRef von Arnim T. Medical treatment to reduce total ischemic burden: total ischemic burden bisoprolol study (TIBBS), a multicenter trial comparing bisoprolol and nifedipine. the TIBBS Investigators. J Am Coll Cardiol. 1995;25:231–8.CrossRef
33.
Zurück zum Zitat Poole-Wilson PA, Kirwan BA, Vokó Z, de Brouwer S, van Dalen FJ, Lubsen J, Investigators ACTION. Safety of nifedipine GITS in stable angina: the ACTION trial. Cardiovasc Drugs Ther. 2006;20:45–54.CrossRefPubMed Poole-Wilson PA, Kirwan BA, Vokó Z, de Brouwer S, van Dalen FJ, Lubsen J, Investigators ACTION. Safety of nifedipine GITS in stable angina: the ACTION trial. Cardiovasc Drugs Ther. 2006;20:45–54.CrossRefPubMed
34.
Zurück zum Zitat Nissen SE, Tuzcu EM, Libby P, et al. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA. 2004;292:2217–25.CrossRefPubMed Nissen SE, Tuzcu EM, Libby P, et al. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA. 2004;292:2217–25.CrossRefPubMed
35.
Zurück zum Zitat De Mots H, Glasser SP. Intermittent transdermal nitroglycerin therapy in the treatment of chronic stable angina. J Am Coll Cardiol. 1989;13:786–95.CrossRef De Mots H, Glasser SP. Intermittent transdermal nitroglycerin therapy in the treatment of chronic stable angina. J Am Coll Cardiol. 1989;13:786–95.CrossRef
36.
Zurück zum Zitat Chrysant SG, Glasser SP, Bittar N, et al. Efficacy and safety of extended-release isosorbide mononitrate for stable effort angina pectoris. Am J Cardiol. 1993;72:1249–56.CrossRefPubMed Chrysant SG, Glasser SP, Bittar N, et al. Efficacy and safety of extended-release isosorbide mononitrate for stable effort angina pectoris. Am J Cardiol. 1993;72:1249–56.CrossRefPubMed
37.
Zurück zum Zitat Markham A, Plosker GL, Goa KL. Nicorandil. an updated review of its use in ischaemic heart disease with emphasis on its cardioprotective effects. Drugs. 2000;60:955–74.CrossRefPubMed Markham A, Plosker GL, Goa KL. Nicorandil. an updated review of its use in ischaemic heart disease with emphasis on its cardioprotective effects. Drugs. 2000;60:955–74.CrossRefPubMed
38.
Zurück zum Zitat Rajaratnam R, Brieger DB, Hawkins R, et al. Attenuation of anti-ischemic efficacy during chronic therapy with nicorandil in patients with stable angina pectoris. Am J Cardiol. 1999;83:1120–4.CrossRefPubMed Rajaratnam R, Brieger DB, Hawkins R, et al. Attenuation of anti-ischemic efficacy during chronic therapy with nicorandil in patients with stable angina pectoris. Am J Cardiol. 1999;83:1120–4.CrossRefPubMed
39.
Zurück zum Zitat Doring G. Antianginal and anti-ischemic efficacy of nicorandil in comparison with isosorbide mononitrate and isosorbide dinitrate: results from two multicenter, double-blind, randomized studies with stable coronary heart disease patients. J Cardiovasc Pharmacol. 1992;20(Suppl 3):S74–81.CrossRefPubMed Doring G. Antianginal and anti-ischemic efficacy of nicorandil in comparison with isosorbide mononitrate and isosorbide dinitrate: results from two multicenter, double-blind, randomized studies with stable coronary heart disease patients. J Cardiovasc Pharmacol. 1992;20(Suppl 3):S74–81.CrossRefPubMed
40.
Zurück zum Zitat Di Somma S, Liguori V, Petitto M, et al. A double-blind comparison of nicorandil and metoprolol in stable effort angina pectoris. Cardiovasc Drugs Ther. 1993;7:119–23.CrossRefPubMed Di Somma S, Liguori V, Petitto M, et al. A double-blind comparison of nicorandil and metoprolol in stable effort angina pectoris. Cardiovasc Drugs Ther. 1993;7:119–23.CrossRefPubMed
41.
Zurück zum Zitat IONA trial. Effect of nicorandil on coronary events in patients with stable angina: the impact of nicorandil in angina (IONA) randomised trial. Lancet. 2002;359:1269–75.CrossRef IONA trial. Effect of nicorandil on coronary events in patients with stable angina: the impact of nicorandil in angina (IONA) randomised trial. Lancet. 2002;359:1269–75.CrossRef
42.
43.
Zurück zum Zitat Chaitman BR, Skettino SL, Parker JO, et al. Anti-ischemic effects and long-term survival during ranolazine monotherapy in patients with chronic severe angina. J Am Coll Cardiol. 2004;43:1375–82.CrossRefPubMed Chaitman BR, Skettino SL, Parker JO, et al. Anti-ischemic effects and long-term survival during ranolazine monotherapy in patients with chronic severe angina. J Am Coll Cardiol. 2004;43:1375–82.CrossRefPubMed
44.
Zurück zum Zitat Chaitman BR, Pepine CJ, Parker JO, et al. Effects of ranolazine with atenolol, amlodipine, or diltiazem on exercise tolerance and angina frequency in patients with severe chronic angina: a randomized controlled trial. JAMA. 2004;291:309–16.CrossRefPubMed Chaitman BR, Pepine CJ, Parker JO, et al. Effects of ranolazine with atenolol, amlodipine, or diltiazem on exercise tolerance and angina frequency in patients with severe chronic angina: a randomized controlled trial. JAMA. 2004;291:309–16.CrossRefPubMed
45.
Zurück zum Zitat Stone PH, Gratsiansky NA, Blokhin A, Huang IZ, Meng L, Investigators ERICA. Antianginal efficacy of ranolazine when added to treatment with amlodipine: the ERICA (efficacy of ranolazine in chronic angina) trial. J Am Coll Cardiol. 2006;48:566–75.CrossRefPubMed Stone PH, Gratsiansky NA, Blokhin A, Huang IZ, Meng L, Investigators ERICA. Antianginal efficacy of ranolazine when added to treatment with amlodipine: the ERICA (efficacy of ranolazine in chronic angina) trial. J Am Coll Cardiol. 2006;48:566–75.CrossRefPubMed
46.
Zurück zum Zitat Weisz G, Généreux P, Iñiguez A, et al. Ranolazine in patients with incomplete revascularisation after percutaneous coronary intervention (RIVER-PCI): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2016;387:136–45.CrossRefPubMed Weisz G, Généreux P, Iñiguez A, et al. Ranolazine in patients with incomplete revascularisation after percutaneous coronary intervention (RIVER-PCI): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2016;387:136–45.CrossRefPubMed
47.
Zurück zum Zitat Alexander KP, Weisz G, Prather K, et al. Effects of ranolazine on angina and quality of life after percutaneous coronary intervention with incomplete revascularization: results from the ranolazine for incomplete vessel revascularization (RIVER-PCI) trial. Circulation. 2016;133:39–47.CrossRefPubMed Alexander KP, Weisz G, Prather K, et al. Effects of ranolazine on angina and quality of life after percutaneous coronary intervention with incomplete revascularization: results from the ranolazine for incomplete vessel revascularization (RIVER-PCI) trial. Circulation. 2016;133:39–47.CrossRefPubMed
48.
Zurück zum Zitat Stanley WC, Marzilli M. Metabolic therapy in the treatment of ischaemic heart disease: the pharmacology of trimetazidine. Fundam Clin Pharmacol. 2003;17:133–45.CrossRefPubMed Stanley WC, Marzilli M. Metabolic therapy in the treatment of ischaemic heart disease: the pharmacology of trimetazidine. Fundam Clin Pharmacol. 2003;17:133–45.CrossRefPubMed
49.
Zurück zum Zitat Peng S, Zhao M, Wan J, Fang Q, Fang D, Li K. The efficacy of trimetazidine on stable angina pectoris: a meta-analysis of randomized clinical trials. Int J Cardiol. 2014;177:780–5.CrossRefPubMed Peng S, Zhao M, Wan J, Fang Q, Fang D, Li K. The efficacy of trimetazidine on stable angina pectoris: a meta-analysis of randomized clinical trials. Int J Cardiol. 2014;177:780–5.CrossRefPubMed
50.
51.
52.
Zurück zum Zitat Gottlieb SO, Sidney O. M.D. Weisfeldt, et al. silent ischemia as a marker for early unfavorable outcomes in patients with unstable angina. N Engl J Med. 1986;314:1214–9.CrossRefPubMed Gottlieb SO, Sidney O. M.D. Weisfeldt, et al. silent ischemia as a marker for early unfavorable outcomes in patients with unstable angina. N Engl J Med. 1986;314:1214–9.CrossRefPubMed
53.
Zurück zum Zitat Gill JB, Cairns JA, Roberts RS, et al. Prognostic importance of myocardial ischemia detected by ambulatory monitoring early after acute myocardial infarction. N Engl J Med. 1996;334:65–71.CrossRefPubMed Gill JB, Cairns JA, Roberts RS, et al. Prognostic importance of myocardial ischemia detected by ambulatory monitoring early after acute myocardial infarction. N Engl J Med. 1996;334:65–71.CrossRefPubMed
54.
Zurück zum Zitat Weiner DA, Ryan T, McCabe C, et al. Prognostic importance of a clinical profile and exercise test in medically treated patients with coronary artery disease. J Am Coll Cardiol. 1984;3:772–7.CrossRefPubMed Weiner DA, Ryan T, McCabe C, et al. Prognostic importance of a clinical profile and exercise test in medically treated patients with coronary artery disease. J Am Coll Cardiol. 1984;3:772–7.CrossRefPubMed
55.
Zurück zum Zitat Prakash M, Myers J, Froelicher VF, et al. Clinical and exercise test predictors of all cause mortality. Chest. 2001;120:1003–13.CrossRefPubMed Prakash M, Myers J, Froelicher VF, et al. Clinical and exercise test predictors of all cause mortality. Chest. 2001;120:1003–13.CrossRefPubMed
56.
Zurück zum Zitat Weiner DA, Ryan TJ, McCabe CH, et al. Significance of silent myocardial ischemia during exercise testing in patients with coronary artery disease. Am J Cardiol. 1987;59:725–9.CrossRefPubMed Weiner DA, Ryan TJ, McCabe CH, et al. Significance of silent myocardial ischemia during exercise testing in patients with coronary artery disease. Am J Cardiol. 1987;59:725–9.CrossRefPubMed
57.
Zurück zum Zitat Thompson C, Jabbour S, Goldberg R, et al. Exercise performance based outcomes of medically treated patients with coronary artery disease and profound ST depression. J Am Coll Cardiol. 2000;36:2140–5.CrossRefPubMed Thompson C, Jabbour S, Goldberg R, et al. Exercise performance based outcomes of medically treated patients with coronary artery disease and profound ST depression. J Am Coll Cardiol. 2000;36:2140–5.CrossRefPubMed
58.
Zurück zum Zitat Lauer MS, Pothier CE, Magid DJ, Smith SS, Kattan MW. An externally validated model for predicting long-term survival after exercise treadmill testing in patients with suspected coronary artery disease and a normal electrocardiogram. Ann Intern Med. 2007;147:821–8.CrossRefPubMed Lauer MS, Pothier CE, Magid DJ, Smith SS, Kattan MW. An externally validated model for predicting long-term survival after exercise treadmill testing in patients with suspected coronary artery disease and a normal electrocardiogram. Ann Intern Med. 2007;147:821–8.CrossRefPubMed
59.
Zurück zum Zitat Pepine CJ, Sharaf B, Andrews TC, et al. Relation between clinical, angiographic and ischemic findings at baseline and ischemia-related adverse outcomes at 1 year in the asymptomatic cardiac ischemia Pilot study. ACIP study group. J Am Coll Cardiol. 1997;29:1483–9.CrossRefPubMed Pepine CJ, Sharaf B, Andrews TC, et al. Relation between clinical, angiographic and ischemic findings at baseline and ischemia-related adverse outcomes at 1 year in the asymptomatic cardiac ischemia Pilot study. ACIP study group. J Am Coll Cardiol. 1997;29:1483–9.CrossRefPubMed
60.
Zurück zum Zitat Mulcahy D, Knight C, Patel D, et al. Detection of ambulatory ischaemia is not of practical clinical value in the routine management of patients with stable angina: a long-term follow-up study. Eur Heart J. 1995;16:317–24.CrossRefPubMed Mulcahy D, Knight C, Patel D, et al. Detection of ambulatory ischaemia is not of practical clinical value in the routine management of patients with stable angina: a long-term follow-up study. Eur Heart J. 1995;16:317–24.CrossRefPubMed
61.
Zurück zum Zitat Gandhi MM, Wood DA, Lampe F. Characteristics and clinical significance of ambulatory myocardial ischemia in men and women in the general population presenting with angina pectoris. J Am Coll Cardiol. 1994;23:74–81.CrossRefPubMed Gandhi MM, Wood DA, Lampe F. Characteristics and clinical significance of ambulatory myocardial ischemia in men and women in the general population presenting with angina pectoris. J Am Coll Cardiol. 1994;23:74–81.CrossRefPubMed
62.
Zurück zum Zitat Hausmann D, Nikutta P, Trappe HJ, Daniel WG, Wenzlaff P, Lichtlen PR. Incidence of ventricular arrhythmias during transient myocardial ischemia in patients with stable coronary artery disease. J Am Coll Cardiol. 1990;16:49–54.CrossRefPubMed Hausmann D, Nikutta P, Trappe HJ, Daniel WG, Wenzlaff P, Lichtlen PR. Incidence of ventricular arrhythmias during transient myocardial ischemia in patients with stable coronary artery disease. J Am Coll Cardiol. 1990;16:49–54.CrossRefPubMed
63.
Zurück zum Zitat Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management Of Patients With Stable Ischemic Heart Disease. J Am Coll Cardiol. 2012;60:e44–e164.CrossRefPubMed Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management Of Patients With Stable Ischemic Heart Disease. J Am Coll Cardiol. 2012;60:e44–e164.CrossRefPubMed
64.
Zurück zum Zitat Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease. Eur Heart J. 2013;34:2949–3003.CrossRefPubMed Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease. Eur Heart J. 2013;34:2949–3003.CrossRefPubMed
65.
Zurück zum Zitat Rogers WJ, Bourassa MG, Andrews TC, et al. Asymptomatic cardiac ischemia Pilot (ACIP) study: outcome at 1 year for patients with asymptomatic cardiac ischemia randomized to medical therapy or revascularization. the ACIP Investigators. J Am Coll Cardiol. 1995;26:594–605.CrossRefPubMed Rogers WJ, Bourassa MG, Andrews TC, et al. Asymptomatic cardiac ischemia Pilot (ACIP) study: outcome at 1 year for patients with asymptomatic cardiac ischemia randomized to medical therapy or revascularization. the ACIP Investigators. J Am Coll Cardiol. 1995;26:594–605.CrossRefPubMed
66.
Zurück zum Zitat Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the coronary artery bypass graft surgery Trialists Collaboration. Lancet. 1994;344:563–70.CrossRefPubMed Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the coronary artery bypass graft surgery Trialists Collaboration. Lancet. 1994;344:563–70.CrossRefPubMed
67.
Zurück zum Zitat Boden WE, O'Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356:1503–16.CrossRefPubMed Boden WE, O'Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356:1503–16.CrossRefPubMed
68.
Zurück zum Zitat The BARI. 2D study group. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009;360:2503–15.CrossRef The BARI. 2D study group. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009;360:2503–15.CrossRef
69.
Zurück zum Zitat Velazquez EJ, Lee KL, Deja MA, Jain A, et al. Coronary-artery bypass surgery in patients with left ventricular dysfunction. N Engl J Med. 2011;364:1607–16.CrossRefPubMedPubMedCentral Velazquez EJ, Lee KL, Deja MA, Jain A, et al. Coronary-artery bypass surgery in patients with left ventricular dysfunction. N Engl J Med. 2011;364:1607–16.CrossRefPubMedPubMedCentral
71.
Zurück zum Zitat Crea F, Camici PG, De Caterina R, Lanza GA. Chronic ischaemic heart disease. In: The ESC textbook of cardiovascular medicine. Oxford; 2009. p. 597–664. Crea F, Camici PG, De Caterina R, Lanza GA. Chronic ischaemic heart disease. In: The ESC textbook of cardiovascular medicine. Oxford; 2009. p. 597–664.
72.
Zurück zum Zitat Andrews TC, Fenton T, Toyosaki N, et al. Subsets of ambulatory myocardial ischemia based on heart rate activity. Circadian distribution and response to anti-ischemic medication. The angina and silent ischemia study group (ASIS). Circulation. 1993;8:92–100.CrossRef Andrews TC, Fenton T, Toyosaki N, et al. Subsets of ambulatory myocardial ischemia based on heart rate activity. Circadian distribution and response to anti-ischemic medication. The angina and silent ischemia study group (ASIS). Circulation. 1993;8:92–100.CrossRef
Metadaten
Titel
Overview of Management of Myocardial Ischemia: a Mechanistic-Based Approach
verfasst von
Gaetano Antonio Lanza
Filippo Crea
Publikationsdatum
18.04.2016
Verlag
Springer US
Erschienen in
Cardiovascular Drugs and Therapy / Ausgabe 4/2016
Print ISSN: 0920-3206
Elektronische ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-016-6662-5

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