Nitrate Therapy in Unstable Angina Pectoris

摘要: Unstable angina was until recently considered to result from progression of an atherosclerotic plaque [31], and superimposed coronary artery spasm at the site lesion thought precipitate ischemic episodes [7, 15]. There is, however, convincing evidence that culprit in unstable is a fissuring which predisposes platelet deposition thrombus formation [6, 10, 14, 17, 46]. Plaque may also play role some patients others increase myocardial oxygen demand rather than reduction flow be contributory [37, 41]. The emphasis treatment therefore should rapid institution therapy with aspirin or heparin combination two [5, 26, 49, 58] overzealous use antianginal drugs, surgery, angioplasty during initial phase [11, 32, 43]. Treatment aspirin, heparin, both reduces mortality incidence infarction [58] but does not relieve anginal pain ischemia immediately. On other hand, intravenous nitroglycerin relieves rapidly plays important management angina. Intravenous used concurrently agents for symptomatic relief its antiischemic effects.