Abstract

A SYSTEMATIC REVIEW ON ANGINA - FOCUSING NITRATES AND NEED OF NEWER AGENTS

Afshan Siddiq*, Fatima Ahmed and Sadia Ghousia Baig

ABSTRACT

Angina is a known symptom for a complicated cardiovascular disease i.e, Ischemic Heart disease. It occurs when there is a mismatch of oxygen demand and supply to myocardium. To cater it, drugs from β blockers, Calcium Channel Blockers, organic nitrates and few newer agents are used. For more than a century, the drug of choice has been nitroglycerin. By the end of 19th century, a phenomenon Nitrate tolerance was observed in individuals consuming nitrate sustain therapy or as a prophylactic agent. Various mechanisms have been proposed in different articles for nitrate tolerance which include compromised biotransformation and also increased oxidative stress. It is one of the reason which limited the clinical efficacy of nitrates in angina. Nowadays newer agents with different mechanism of action are introduced like Ivabradine, Ranolazine, Trimetazidineand Nicorandil which will be discussed in this review in detail in terms of their efficacy in improving individual’s health and quality of life.

Keywords: Angina, Ischemic Heart Disease, Myocardium, Nitrate Tolerance, Quality of Life.