Chronic stable angina: Pathophysiology and innovations in treatment

The incidence of chronic stable angina has risen significantly over the past few decades and may affect as many as 15 000-40 000 individuals per million in the US and Europe. Whereas there are fundamental pathophysiologic differences between chronic stable angina and acute coronary syndrome, the importance of optimal medical therapy in all stages of coronary artery disease cannot be overemphasized. As the initial manifestation of coronary artery disease in nearly half of all patients, diagnosis of stable angina represents a valuable opportunity to initiate evidence-based therapies to decrease mortality among patients with coronary artery disease, in addition to symptomatic treatment. However, despite aggressive medical therapy and if appropriate, revascularization, many patients still have refractory angina. In this article, the pathophysiology, currently recommended clinical management and emerging therapies to treat symptoms of chronic stable angina are reviewed.