Ranexa™ for Chronic Angina An Unmet Need. Eugene Braunwald, MD, FACC Harvard Medical School Brigham and Women’s Hospital.
Eugene Braunwald, MD, FACC
Harvard Medical School
Brigham and Women’s Hospital
Heberden. Medical Transaction, Royal College of Physicians
of London. 1772;2:59-67.
Studies of VA patients with CAD demonstrate the following comorbidity incidence rates
Symptom relief(N = 1403)
Treatment of acute myocardial infarction(N = 352)
. . . the overall prevalence of angina was 26%Persistent Angina DespitePercutaneous Intervention (PCI)
Angina at 1-yr follow-up by events during or after initial PCI
Holubkov R, et al. NHLBI Dynamic Registry. Am Heart J. 2002;144:826-833.
1 yr after optimal revascularization by stenting or surgery for relief of ischemia (ie, not to prolong survival) …
TABLE 3. STATUS WITH RESPECT TO ANGINA AND MEDICATION USE AND QUALITY OF LIFE AMONG SURVIVING PATIENTS.*
~ 60% to 80% are still taking anti-anginal medications
~ 10% to 20% still have angina
Serruys PW, et al. for the ARTS Study Group. N Engl J Med.2001;344:1117-1124.
ACS = acute coronary syndrome
SAQ = Seattle Angina Questionnaire
Rumsfeld JS, et al. Am Heart J.2003;145:492.
When angina cannot be eliminated by current drugs, it is often their additive effects on BP, HR, AV conduction, and other important side effects (depression, fatigue, sexual/sleep disorders, etc.) that preclude complete relief.