Optimal management of chronic coronary syndromes: what are the goals and therapeutic strategies? What therapeutic scheme do we strive for? Review article

Abstract

The ISCHEMIA study was conducted to identify a group of high-risk patients in whose adding revascularization improves prognosis. The three-year observation did not show the advantage of this method over conventional pharmacotherapy in: total mortality, heart rate, hospitalization for cardiological reasons, and net clinical benefit. No statistically significant difference was found in cardiovascular and total mortality, nor in myocardial infarction. Optimal pharmacotherapy remains the basis for the treatment of patients with chronic coronary artery disease. Its purpose is both to reduce cardiovascular risk and to alleviate symptoms. The latter goal can be achieved with treatment, which position in the guidelines has recently been revised. Those drugs do not cause hemodynamically significant side effects, and added to others reduces the number of angina attacks and the need for nitroglycerin, as well as improves exercise tolerance.