|Olariu CT, Olariu L|
Current Therapeutic Options in Unstable Angina
Journal of Clinical and Basic Cardiology 2001; 4 (4): 269-274
Keywords: Antiplättchentherapie, Betablocker, Glykoprotein-IIb-IIIa-Antagonist, instabile Angina pectoris, Therapie, antiplatelets, beta-blocker, GP antagonists, therapy, unstable angina
Unstable angina represents a serious challenge in everyday practice. In the past 10 years we have witnessed enormous progress in risk stratification and treatment of this kind of patient. This paper focuses on the current medical armamentarium against this acute coronory syndrome. While some old drugs like aspirin and beta-blockers had a well proved efficacy, the use of newer drugs such as low molecular weight heparins, glycoprotein IIb/IIIa receptor antagonists, thienopyridines is evolving with impressive results. The introduction of intravenous glycoprotein GP IIb/IIIa receptor antagonists represents the most important therapeutic advance especially in the setting of percutaneous coronary intervention. Surprisingly, the oral form of this class is a big therapeutic failure according to the present trials. Low molecular weight heparins (especially enoxaparine) appear to be a reasonable and efficient alternative to standard heparin. Other drugs such as direct thrombin inhibitors have not found a definite therapeutic niche whereas lipid lowering drugs (particularly statins) administered aggressively in high doses seem to win a more consolidated position as part of maximal therapy.