OPTIMAL DRUG TREATMENT PATIENTS WITH ANGINA PECTORIS

Download full text PDF
Issue: 
4
Year: 
2017

Professor N. Mazur, MD Russian Medical Academy of continuous professional Education, Moscow

In this clinical seminar (lecture) we argue the urgency to optimize the drug therapy in patients with stable angina pectoris. Today the quality of their treatment remains lower than it could be. In majority of cases the applied drug therapy does not allow to control the risk factors of inappropriate prognosis. Inadequate treatment of angina pectoris contributes to very high mortality rate due to cardiac diseases in Russian Federation. Prescription of drugs with proven positive effect is often based on non-optimal schemes. Moreover, there is a wide-spread tendency to prescribe metabolic drugs to patients with cardiovascular pathology and other diseases notwithstanding the fact that the pharmacoeconomic validity оf such drugs remains to be demonstrated.

Keywords: 
cardiology
angina pectoris
statins
antiagregates
β-blockers
calcium channel blockers
ivabradine
nitrates
nicorandil
trimetazidine
ranolazine
meldonium



It appears your Web browser is not configured to display PDF files. Download adobe Acrobat или click here to download the PDF file.

References: 
  1. http://www.gks.ru/wps/wcm/connect/rosstatmain/rosstat/ru/statistics/population/ demography
  2. The Academic Research Organization Consortium for Continuing Evaluation of Scientific Studies – Cardiovascular (ACCESS CV). Sharing Data from Cardiovascular Clinical Trials – A Proposal // N. Engl. J. Med. – 2016; 375: 407–9.
  3. Sajutina E.V., Chigineva V.V., Zolozova E.A. i dr. Kontrol' ishemii miokarda u bol'nyh stenokardiej naprjazhenija s mnogososudistym ateroskleroticheskim porazheniem // Kardiologija. – 2012; 8: 15–9.
  4. Karlova N.A., Zolozova E.A., Pshenitsin A.I. i dr. Otsenka terapevticheskoj effektivnosti i bezopasnosti original'nogo preparata bisoprolola i ego dzhenerika biprola u bol'nyh stabil'noj stenokardiej // Kardiologija. – 2015; 1: 23–8.
  5. Euro Heart Survey of stable angina: prospective observational study // Eur. Heart J. – 2005; 26: 1011–22.
  6. ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, 2013.
  7. ESC guidelines stable coronary artery disease // Eur. Heart J. – 2013; 34 (38): 2927–8.
  8. PEGASUS-TIMI 54 Steering Committee and Investigators. Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction // N. Engl. J. Med. – 2015; 372: 1791–800.
  9. Serebruany V. The TRITON versus PLATO trials: differences beyond platelet inhibition // Thromb. Haemost. – 2010; 103 (2): 259–61.
  10. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE) // Lancet. – 1996; 348 (9038): 1329–39.
  11. Lee M., Wu Y., Saver J. et al. Is clopidogrel better than aspirin following breakthrough strokes. A retrospective cohort study // BMJ Open. – 2014; 4 (12): e006672.
  12. Mazur N.A. Antiagregantnaja terapija u bol'nyh ishemicheskoj bolezn'ju serdtsa: nereshennye problemy // Kardiologija. – 2016; 1: 66–70.
  13. Everly M., Heaton P., Cluxton R. Beta-Blocker Underuse in Secondary Prevention of Myocardial Infarction // Ann. Pharmacother. – 2003; 38: 286–93.
  14. Le S. Prognostic Significance of Resting Heart Rate and Use of β-Blockers in Atrial Fibrillation and Sinus Rhythm in Patients With Heart Failure and Reduced Ejection Fraction: Findings From the Swedish Heart Failure Registry // Circ. Heart Fail. – 2015; 8 (5): 871–9.
  15. Flather M., Shibata M., Coats A. et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS) // Eur. Heart J. – 2005; 26 (3): 215–25.
  16. Mazur N.A. Vnezapnaja smert' bol'nyh ishemicheskoj bolezn'ju serdtsa / M.: Meditsina, 1985; 121–42.
  17. Hansen J. Treatment with verapamil after an acute myocardial infarction. Review of the Danish studies on verapamil in myocardial infarction (DAVIT I and II) // Drugs. – 1991; 42 (Suppl. 2): 43–53.
  18. Rehnqvist N., Hjemdahl P., Billing E. et al. Effects of metoprolol vs verapamil in patients with stable angina pectoris. The Angina Prognosis Study in Stockholm (APSIS) // Eur. Heart J. – 1996; 17 (1): 76–81.
  19. The Multicenter Diltiazem Postinfarction Trial Research Group The effect of diltiazem on mortality and reinfarction after myocardial infarction // N. Engl. Med. – 1988; 319 (7): 385–92.
  20. Poole-Wilson P., Lubsen J., Kirwan B. et al. Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial // Lancet. – 2004; 364 (9437): 849–57.
  21. Mazur N.A. Prakticheskaja kardiologija / M.: Medpraktika-M, 2015; 109–37.
  22. Horinaka Sh. Vlijanie nikorandila na chastotu serdechno-sosudistyh sobytij u patsientov s koronarnoj bolezn'ju serdtsa // Ros. kardiol. zhurn. – 2011; 2 (88): 82–90.
  23. Sakata Y., Nakatani D., Shimizu M. et al. Oral treatment with nicorandil at discharge is associated with reduced mortality after acute myocardial infarction // J. Cardiol. – 2012; 59 (1): 14–21.
  24. IONA Study Group. Impact of nicorandil in angina: subgroup analyses // Heart. – 2004; 90 (12): 1427–30.
  25. Stoschitzky K., Rezkalla S., Klone R. Noevidenceof nitrate tolerance with Nicorandil // Eur. Heart J. – 2012; 32 (Abstract Supplement): 470.
  26. Sekiya M., Sato M., Funada J. et al. Effects of the long-term administration of nicorandil on vascular endothelial function and the progression of arteriosclerosis // J. Cardiovasc. Pharmacol. – 2005; 46 (1): 63–7.
  27. Patel D., Purcell H., Fox K. on behalf of the CESAR 2 investigation. Cardioprotection by opening of the KATP channel in unstable angina // Eur. Heart J. – 1999; 20: 51–7.
  28. Eguchi Y., Takahari Y., Higashijima N. et al. Nicorandil Attenuates FeCl3-Induced Thrombus Formation Through the Inhibition of Reactive Oxygen Species Production // Circ. J. – 2009; 73 (3): 554–61.
  29. Izumiya Y., Kojima S., Araki S. et al. Long-term use of oral nicorandil stabilizes coronary plaque in patients with stable angina pectoris // Atherosclerosis. – 2011; 214 (2): 415–21.
  30. Markham A., Plosker G., Goa K. Nicorandil. An updated review of its use in ischaemic heart disease with emphasis on its cardio-protective effects // Drugs. – 2000; 60: 955–74.
  31. Kasama S., Toyama T., Sumino H. et al. Long-term nicorandil therapy improves cardiac sympathetic nerve activity after reperfusion therapy in patients with first acute myocardial infarction // J. Nucl. Med. – 2007; 48 (10): 1676–82.
  32. Kasama S., Toyama T., Hatori T. et al. Comparative effects of nicorandil with isosorbide mononitrate on cardiac sympathetic nerve activity and left ventricular function in patients with ischemic cardiomyopathy // Am. Heart J. – 2005; 150 (3): 477.e1–477.e8.
  33. Evans M., Carrero J., Szummer K. et al. Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Myocardial Infarction Patients With Renal Dysfunction // J. Am. Coll. Cardiol. – 2016; 67: 1687–97.
  34. Sleight P. The HOPE Study (Heart Outcomes Prevention Evaluation) // J. Renin Angiotensin Aldosterone Syst. – 2000; 1 (1): 18–20.
  35. Campbell D. A review of Perindopril in the reduction of cardiovascular events // Vasc. Health Risk Manag. – 2006; 2 (2): 117–24.
  36. Tardif J., Ponikowski P., Kahan T. ASSOCIATE Study Investigators. 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 (5): 540–8.
  37. Fox K., Ford I., Steg P. et al. Ivabradine in stable coronary artery disease without clinical heart failure // N. Engl. J. Med. – 2014; 371 (12): 1091–9.
  38. Tanboğa İ., Topçu S., Aksakal E. et al. The Risk of Atrial Fibrillation With Ivabradine Treatment: A Meta-analysis With Trial Sequential Analysis of More Than 40 000 Patients // Clin. Cardiol. – 2016; 39 (10): 615–20.
  39. Szwed H., Sadowski Z., Elikowski W. et al. Combination treatment in stable effort angina using trimetazidine and metoprolol: results of a randomized, double-blind, multicentre study (TRIMPOL II). TRIMetazidine in POLand // Eur. Heart J. – 2001; 2 (24): 2267–74.
  40. The EMIP-FR Group. Effect of 48-h intravenous trimetazidine on short- and long-term outcomes of patients with acute myocardial infarction, with and without thrombolytic therapy; A double-blind, placebo-controlled, randomized trial European Myocardial Infarction Project – Free Radicals // Eur. Heart J. – 2000; 21 (18): 1537–46.
  41. www.EMA/412151/2012EMEA/H/A-31/130521 June 2012.
  42. Chaitman B., Pepine C., Parker J. 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 (3): 309–16.
  43. Melloni C., Newby L. Metabolic efficiency with ranolazineforless ischemia in non-ST elevation acute coronary syndromes (MERLIN TIMI-36) study // Expert Rev. Cardiovasc. Ther. – 2008; 6 (1): 9–16.
  44. Statsenko M.E., Turkina S.V. Metabolicheskaja kardioprotektsija mel'doniem u bol'nyh ishemicheskoj bolezn'ju serdtsa: itogi i perspektivy // Lechaschij vrach. – 2012; 7: 96–103.