Optimizing Management of Stable Angina: A Patient-Centered Approach Integrating Revascularization, Medical Therapy, and Lifestyle Interventions (JACC August 2024-2)

Description

Angina pectoris may arise from obstructive coronary artery disease (CAD) or in the absence of significant CAD (ischemia with non-obstructed coronary arteries, INOCA). Therapeutic strategies for patients with angina and obstructive CAD focus on reducing cardiovascular events and relieving symptoms, while in INOCA the focus shifts toward managing functional alterations of the coronary circulation. In obstructive CAD, coronary revascularization might improve angina status, although a significant percentage of patients present angina persistence/recurrence, suggesting the presence of functional mechanisms along with epicardial CAD. In patients with INOCA, performing a precise endotype diagnosis is crucial to allow a tailored therapy targeted on the specific pathogenic mechanism. In this expert opinion paper, we review the evidence for the management of angina, highlighting the complementary role of coronary revascularization, optimal medical therapy, and lifestyle interventions, and underscoring the importance of a personalized approach that targets the underlying pathobiology.

Editors
Editor-in-Chief
Harlan M. Krumholz, MD, SM, FACC

CME Editor
Ragavendra R. Baliga, MD

Authors
Valerian L. Fernandes, MBBS, FACC
Manoj Ambalavanan, MD

Important Dates
Date of Release: August 12, 2024
Term of Approval/Date of CME/MOC Expiration: August 11, 2025

Summary


Availability:	On-Demand
	Expires on Aug 11, 2025


Cost:	FREE


Credit Offered:	1 CME Credit 1 ABIM-MOC Point