Division of Cardiovascular Diseases, Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX, 79905, USA.
Curr Cardiol Rep. 2020 Jan 29;22(3):12. doi: 10.1007/s11886-020-1262-1.
To examine the current clinical evidence behind the use of calcium channel blockers (CCB) and beta-blockers (BB) for the treatment of patients with stable coronary artery disease (SCAD) and their effect on mortality.
Current evidence suggests that BB use as a first line antianginal medication is associated with lower 5-year all-cause mortality only in patients who had MI within a year. This could be driven due to their effects reducing the sympathetic neuro-hormonal activation of more acutely ill patients. The use of CCB as an antianginal therapy, although proven effective in multiple trials both as monotherapy and combined with other agents, has not shown mortality benefit. Both BB and CCB are effective antianginals, and the selection among them depends on the patient clinical presentation and comorbidities. BB are the only ones that have shown survival benefit in SCAD, particularly the first year post-MI.
探讨钙通道阻滞剂（CCB）和β受体阻滞剂（BB）治疗稳定型冠状动脉疾病（SCAD）患者的临床证据及其对死亡率的影响。
目前的证据表明，BB 作为一线抗心绞痛药物的使用与 5 年内全因死亡率降低相关，仅在一年内发生心肌梗死的患者中如此。这可能是由于它们的作用降低了更急性发病患者的交感神经激素激活。尽管 CCB 在多项试验中作为单药和与其他药物联合使用均被证明是有效的抗心绞痛治疗方法，但它并未显示出对死亡率的益处。BB 和 CCB 都是有效的抗心绞痛药物，它们的选择取决于患者的临床表现和合并症。BB 是唯一在 SCAD 中显示出生存获益的药物，特别是在心肌梗死后的第一年。
