Secco Gioel G, Parisi Rosario, Mirabella Francesca, Rognoni Andrea, Lupi Alessandro, De Luca Giuseppe, Marino Paolo N, Fattori Rossella, Cremonesi Alberto, Castriota Fausto
Coronary Care Unit and Catheterization Laboratory "Maggiore della Carità" Hospital Corso Mazzini 18, 28100 Novara, Italy.
Cardiovasc Hematol Agents Med Chem. 2015;13(1):21-4. doi: 10.2174/1871525713666141219114240.
Since the first human catheterization performed by Forssman in 1929 angioplasty equipment and medical therapies have undergone considerable evolution and technical improvement allowing interventionalists to perform more complex procedures and solving most of the percutaneous limitations. While percutaneous coronary intervention (PCI) has dramatically changed the outcome in the Acute Coronary Syndrome (ACS) setting, its role in the treatment of chronic stable angina is still debated. Stable coronary artery disease (SCAD) is a major public health issue and its prevalence is still increasing in the industrialized world. The correct treatment sees a multi-strategy approach aimed to a relief of symptoms, prevention of future cardiac events and survival improvement. In so forth, treatment strategies include optimal medical therapy (OMT) alone or combined with percutaneous or surgical coronary revascularization. Despite this, angina remains poorly controlled in the vast majority of CAD patients. Traditional agents such Beta-blockers or Calcium channel blockers or short and long acting nitrates have been used as first-line anti-anginal therapy for several years. Nowadays newer and more effective drugs usually used on top of older medical treatment have become available.
自1929年福斯曼进行首例人体导管插入术以来，血管成形术设备和医学疗法经历了相当大的发展和技术改进，使介入专家能够进行更复杂的手术，并解决了大多数经皮治疗的局限性。虽然经皮冠状动脉介入治疗（PCI）在急性冠状动脉综合征（ACS）的治疗中显著改变了治疗结果，但其在慢性稳定型心绞痛治疗中的作用仍存在争议。稳定型冠状动脉疾病（SCAD）是一个重大的公共卫生问题，在工业化国家其患病率仍在上升。正确的治疗采用多策略方法，旨在缓解症状、预防未来心脏事件并提高生存率。因此，治疗策略包括单独的优化药物治疗（OMT）或与经皮或外科冠状动脉血运重建相结合。尽管如此，绝大多数CAD患者的心绞痛仍控制不佳。传统药物如β受体阻滞剂、钙通道阻滞剂或短效和长效硝酸盐已作为一线抗心绞痛治疗药物使用多年。如今，通常在旧有药物治疗基础上加用的更新、更有效的药物已经出现。
