Non-Antithrombotic Treatment of Acute Coronary Syndromes: Role of Beta-Blockers, Calcium Channel Blockers,and Nitrates

摘要

Beta-blockers, calcium channel blockers, and nitrates are anti-ischemic agents with proven efficacy in relieving angina in patients with coronary artery disease. Although these agents differ in their mechanisms of action, they increase coronary blood flow and reduce myocardial oxygen demand. These effects can be expected to be of benefit in acute coronary syndromes like unstable angina (UA) and acute myocardial infarction (AMI). However, relieving pain is only a minor goal in the treatment of unstable coronary syndromes, the major goals being the treatment of myocardial ischemia, the preservation of left ventricular function, and the improvement of prognosis.In this chapter we summarize the extent of the available evidence on the effect of these agents on prognosis, especially the occurrence of myocardial infarction and mortality, in patients with AMI and UA.