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What's the best treatment for angina?

September 28, 2015 | John Murray
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Cardio experts are not quite sure whether invasive treatments or medication and exercise are the safest and most effective way to treat a cardiac condition called ischemic heart disease, that may manifest as angina (chest pain) or angina-like symptoms.

Differing approaches

A team of UCI Health experts involving cardiology, cardiothoracic surgery, nephrology and cardiothoracic imaging with Dr. Mayil Krishnam as lead investigator are participating in a research study comparing medical and invasive approaches to treat ischemia and determine which is the better and safer choice.

“Ischemia occurs in patients with moderate to severe narrowing of the heart arteries due to a buildup of cholesterol,” said Krishnam. “When a heart artery narrows, some part(s) of the heart may not receive enough blood to work normally.”

More than 10 million Americans suffer from the condition. According to the American Heart Association, 500,000 more people are diagnosed each year.

Two treatments compared

Krishnam said the study will compare the two standard ischemia treatments:

  • Conservative treatment or optimal medical therapy, which uses medicines and lifestyle changes to control symptoms (angina or chest pain) and reduce serious events (such as heart attack).
  • Invasive treatment, which uses a procedure to open a narrowed artery and/or heart surgery to bypass the problem artery. Stents are small metal mesh tubes that are placed into heart arteries to prop them open. Bypass is a surgical operation to insert a blood vessel from your leg or chest to go around the blocked area in the heart artery. Doctors and patients make the choice between stents and bypass surgery based on which procedure is thought to provide the better result.

He said both treatments are used by doctors around the world and are not experimental. However, it is not known whether using stents or bypass surgery is better than using modern medicine and lifestyle changes alone for saving lives and preventing heart attacks.

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