Anti-anginal drugs: Systematic review and clinical implications.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
15 05 2019
Historique:
received: 18 10 2018
revised: 17 11 2018
accepted: 03 12 2018
pubmed: 13 12 2018
medline: 24 12 2019
entrez: 13 12 2018
Statut: ppublish

Résumé

The cornerstone of the treatment of patients affected by stable angina is based on drugs administration classified as first (beta-blockers, calcium channel blockers, short acting nitrates) or second line treatment (long-acting nitrates, ivabradine, nicorandil, ranolazine and trimetazidine). However, few data on comparison between different classes of drugs justify that one class of drugs is superior to another. We performed a systematic review of the literature following PRISMA guidelines. i) paper published in English; ii) diagnosis of stable coronary disease; iii) randomized clinical trial; iv) comparison of two anti-angina drugs; v) a sample size >100 patients; vi) a follow-up lasting at least 2 weeks; vii) paper published after 1999, when a meta-analysis of trials comparing beta-blockers, calcium antagonists, and nitrates for stable angina of Heidenreich et al. was published. to establish whether the categorization in first and second line antianginal treatment is scientifically supported. Eleven trials fulfilled inclusion criteria. The results show that there is a paucity of data comparing the efficacy of antianginal agents. The little data available show that there are not compounds superior to others in terms of improvement in exercise test duration, frequency of anginal attacks, need for sub-lingual nitroglycerin. The categorization of antianginal drug in first and second line is not confirmed.

Sections du résumé

BACKGROUND
The cornerstone of the treatment of patients affected by stable angina is based on drugs administration classified as first (beta-blockers, calcium channel blockers, short acting nitrates) or second line treatment (long-acting nitrates, ivabradine, nicorandil, ranolazine and trimetazidine). However, few data on comparison between different classes of drugs justify that one class of drugs is superior to another.
METHODS
We performed a systematic review of the literature following PRISMA guidelines.
INCLUSION CRITERIA
i) paper published in English; ii) diagnosis of stable coronary disease; iii) randomized clinical trial; iv) comparison of two anti-angina drugs; v) a sample size >100 patients; vi) a follow-up lasting at least 2 weeks; vii) paper published after 1999, when a meta-analysis of trials comparing beta-blockers, calcium antagonists, and nitrates for stable angina of Heidenreich et al. was published.
OUTCOME
to establish whether the categorization in first and second line antianginal treatment is scientifically supported.
RESULTS
Eleven trials fulfilled inclusion criteria. The results show that there is a paucity of data comparing the efficacy of antianginal agents. The little data available show that there are not compounds superior to others in terms of improvement in exercise test duration, frequency of anginal attacks, need for sub-lingual nitroglycerin.
CONCLUSION
The categorization of antianginal drug in first and second line is not confirmed.

Identifiants

pubmed: 30538056
pii: S0167-5273(18)36094-7
doi: 10.1016/j.ijcard.2018.12.008
pii:
doi:

Substances chimiques

Adrenergic beta-Antagonists 0
Calcium Channel Blockers 0
Vasodilator Agents 0

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

55-63

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Copyright © 2018 Elsevier B.V. All rights reserved.

Auteurs

Rita Pavasini (R)

Centro Cardiologico Universitario, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Cona, Ferrara, Italy. Electronic address: pvsrti@unife.it.

Paolo G Camici (PG)

Vita Salute University and San Raffaele Hospital, Via Olgettina Milano, 58-60, 20132 Milan, Italy.

Filippo Crea (F)

Department of Cardiovascular and Thoracic Sciences, Catholic University, Largo Francesco Vito, 1, 00168 Rome, Italy.

Nicolas Danchin (N)

Cardiology, European Hospital Georges-Pompidiou, 20 Rue Leblanc, 75015 Paris, France.

Kim Fox (K)

National Heart and Lung Institute, Imperial College and Institute of Cardiovascular Medicine and Science, Royal Brompton Hospital, Sydney Street, London SW36NP, UK.

Athanasios J Manolis (AJ)

Department of Cardiology, Asklepeion General Hospital, 1, Vas. Pavlou Street, 16673 Voula, Athens, Greece.

Mario Marzilli (M)

Cardiothoracic Department, Lungarno Antonio Pacinotti, 43, 56126 Pisa, Italy; Nottola Cardiology Division, Località Nottola, 53045, Ospedali Riuniti Valdichiana Sudest, Siena, Italy.

Giuseppe M C Rosano (GMC)

Clinical Academic Group, St George's Hospitals NHS Trust, Blackshaw Road, London SW17 0QT, UK; Department of Medical Sciences, IRCCS San Raffaele, Via della Pisana, 235, 00163 Rome, Italy.

José L Lopez-Sendon (JL)

Cardiology Department, Hospital Universitario La Paz, IdiPaz, Paseo de la Castellana 261, Madrid 28036, Spain.

Fausto Pinto (F)

Hospital Universitário de Santa Maria/Centro Hospitalar Lisboa Norte, Centro Académico de Medicina de Lisboa, Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.

Cristina Balla (C)

Centro Cardiologico Universitario, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Cona, Ferrara, Italy.

Roberto Ferrari (R)

Centro Cardiologico Universitario, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Cona, Ferrara, Italy; Maria Cecilia Hospital, GVM Care & Research, Via Corriera 1, Cotignola, RA, Italy.

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Classifications MeSH