Delahaye J P, Milon H, Saint-Pierre A, Gaspard P, Ninet J
Arch Mal Coeur Vaiss. 1983 Feb;76 Spec No:117-22.
The limitations of medical treatment in angina pectoris depend on its efficacity and indications. 1. Efficacity of medical treatment.--Anti-anginal drugs are able to relieve anginal pain in at least 3/4 of cases. However, the ability of medical measures (diet, exercise, stopping smoking, hypolipidemic drugs, antihypertensive drugs, anticoagulants, platelet anti-aggregants, antiarrhythmics, inotropic agents, vasodilators and diuretics) to prevent coronary atherosclerosis delay its progression and prevent its complications--so increasing the life expectancy of coronary patients--remains very uncertain. 2. Frontiers and judications of medical treatment.--Coronary patients with few or no symptoms appear to be best suited for long-term anti-anginal treatment with long acting nitrate derivatives and/or betablockers. The ability of the latter group to increase the life expectancy of all coronary patients remains to be shown. The limits of the indications of medical treatment are more difficult to define either by purely subjective criteria (incapacitating angina after trials of anti-anginal drugs at adapted doses) or by "objective" criteria (ergometry, coronary angiography).
心绞痛的药物治疗局限性取决于其疗效和适应证。1. 药物治疗的疗效。——抗心绞痛药物能够在至少3/4的病例中缓解心绞痛症状。然而，药物措施（饮食、运动、戒烟、降血脂药物、抗高血压药物、抗凝剂、血小板抗聚集剂、抗心律失常药、正性肌力药、血管扩张剂和利尿剂）预防冠状动脉粥样硬化、延缓其进展以及预防其并发症——从而提高冠心病患者预期寿命——的能力仍然非常不确定。2. 药物治疗的前沿与适应证。——症状很少或无症状的冠心病患者似乎最适合使用长效硝酸盐衍生物和/或β受体阻滞剂进行长期抗心绞痛治疗。后一组药物提高所有冠心病患者预期寿命的能力仍有待证实。无论是通过纯粹主观的标准（在使用合适剂量的抗心绞痛药物试验后出现致残性心绞痛）还是“客观”标准（运动试验、冠状动脉造影），药物治疗适应证的界限都更难界定。
