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continued:

Angina treatment: Stents, drugs, lifestyle changes — What's best?

So which angina treatment is better — angioplasty and stenting or medications?

Your medical condition will determine whether having angioplasty and stenting or taking medications will work better for you. Talk to your doctor about which angina treatment is best for your situation. Consider this:

  • People who have angioplasty and stenting first may feel better quicker. For example, their chest pain may decrease quicker than those who just take medication. However, after five years those who only take medication usually have the same level of pain relief (less chest pain) than those who had angioplasty and stenting.
  • People who take only medications for angina may not feel better as quickly, but medications require no recovery time and are less expensive than angioplasty and stenting. If you choose to take medications to treat your angina, it's important that you take them exactly as your doctor says so that you get the most benefit.

What if your angina treatment doesn't work?

If you try medication and lifestyle changes first, but they don't relieve your angina, angioplasty and stents may be another option. It might be reasonable to try more-conservative steps first — medication and lifestyle therapy — before considering a stent. Talk to your doctor if you're concerned that medications or stents aren't controlling your angina. Remember that with either treatment plan, lifestyle changes are important.

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References
  1. Angina. National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Angina/Angina_All.html. Accessed Aug. 17, 2010.
  2. Cardiel EA, et al. Current analysis of the results of the COURAGE trial: Has an optimal treatment been reached in clinical practice? American Journal of Cardiovascular Drugs. 2009;9(suppl 1):19.
  3. Maron DJ, et al. Impact of an initial strategy of medical therapy without percutaneous coronary intervention in high-risk patients from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) Trial. American Journal of Cardiology. 2009;104:1055.
  4. Boden WE, et al. Impact of optimal medical therapy with or without percutaneous coronary intervention on long-term cardiovascular end points in patients with stable coronary artery disease (from the COURAGE Trial). American Journal of Cardiology. 2009;104:1.
  5. Mancini GB, et al. Quantitative results of baseline angiography and percutaneous coronary intervention in the COURAGE trial. Circulation: Cardiovascular Quality and Outcomes. 2009;2:320.
  6. Angina pectoris treatments. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4496 Accessed Aug. 16, 2010.
  7. Vadnais DS, et al. Emerging clinical role of ranolazine in the management of angina. Therapeutics and Clinical Risk Management. 2010;6:517.
HB00091 Feb. 11, 2011

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