Despite the wealth of treatments available for the management of angina pectoris, a significant proportion of patients remain refractory. These patients seem to be survivors, so that an individual with refractory angina may suVer with it for many years; consequently patients with refractory angina pectoris usually require multiple admissions, often to expensive cardiac units. Recently transmyoc...

Refractory angina pectoris, defined as angina refractory to maximal medical therapy and standard coronary revascularization procedures, remains a significant health problem in the United States and the world. Despite a panoply of recent therapeutic advances, patients with refractory angina pectoris are not adequately treated; therefore, scientists have been investigating new technologies to hel...

Background Patients with unstable angina despite intensive medical therapy, ie, refractory angina, are at high risk for developing thrombotic complications: myocardial infarction or coronary occlusion during percutaneous transluminal coronary angioplasty (PTCA). Chimeric 7E3 (c7E3) Fab is an antibody fragment that blocks the platelet glycoprotein (GP) Ib/IIIa receptor and potently inhibits plat...

OBJECTIVES Refractory angina patients suffer debilitating chest pain despite optimal medical therapy and previous cardiovascular intervention. Cardiac rehabilitation is often not prescribed due to a lack of evidence regarding potential efficacy and patient suitability. A randomised controlled study was undertaken to explore the impact of cardiac rehabilitation on cardiovascular risk factors, ph...

OBJECTIVE To discriminate between chronic inflammation and acute activation of the plaque immune response in culprit lesions of patients with acute coronary syndromes. DESIGN Retrospective study. SETTING Tertiary referral centre. SUBJECTS 71 patients having coronary atherectomy were classified according to their ischaemic syndrome: stable angina (n = 23); stabilised unstable angina (n = 1...

INTRODUCTION As more patients survive coronary events, the prevalence of patients with refractory angina pectoris is increasing. The aim was to evaluate the effects of enhanced external counterpulsation (EECP) and spinal cord stimulation (SCS) and compare with optimal medically treated patients with refractory angina. METHODS 153 patients with refractory angina were treated with either EECP, ...

We describe a case of Prinzmetal’s angina that is refractory to medical therapy but responded fully after percutaneous coronary intervention. This case shows that there is a role for percutaneous coronary intervention in refractory variant angina as long as a culprit lesion within the vasospastic segment can be identified.

An increasing number of patients have advanced coronary artery disease with ischemic symptoms that are refractory to medical therapy and revascularization. With the increasing adoption of percutaneous revascularization of chronic total occlusions, previously nonrevascularizable vessels may now be targets for revascularization, which may change the landscape of refractory angina. Several nonphar...