Treatment of coronary heart disease

  At present, there are three methods of coronary artery disease treatment: medication, interventional treatment and surgical bypass surgery. The purpose of drug therapy for coronary heart disease is to relieve symptoms, reduce the onset of angina pectoris and the occurrence of myocardial infarction and sudden death, and delay the development of coronary artery lesions, and drug therapy is the foundation. The role of drug therapy is to increase myocardial blood flow, increase blood oxygen supply, reduce myocardial oxygen consumption, improve vascular endothelial function, prevent electrical and structural remodeling of the myocardium, and protect myocardial function.  Pharmacological treatment includes: ① Nitrate drugs (nitroglycerin, cardiac pain relief, isosorbide 5-mononitrate, long-acting nitroglycerin preparations, etc.).  ②Anticoagulant therapy/antiplatelet therapy. Antiplatelet drugs mainly include aspirin, clopidogrel (Bolivar), abciximab, prostacyclin, prostaglandin E1, etc. Anticoagulant drugs mainly include heparin and low molecular heparin, leucovorin, warfarin, etc.  ③ β-blockers, commonly used drugs include metoprolol (50-100 mg/day), atenolol (25-50 mg/day), bisoprolol (Conco) (2.5-5 mg/day) and carvedilol (6.125-12.5 mg/day) which also has the effect of α-blocker, aromalol (Almal) (10 mg/day), etc.  ④Calcium antagonists, commonly used drugs include verapamil (40 mg, 2 times/day), nifedipine (10 mg, 3 times/day), nifedipine controlled-release (Byxin Tong) (30 mg/day), extended-release (Loxopro) (5 mg/day), diltiazem (thiodiazepine, Hershey) (30 mg, 3 times/day), etc.  ⑤ Angiotensin-converting enzyme inhibitors/aldosterone receptor antagonists, commonly used drugs: enalapril (10 mg/day), benazepril (10 mg/day), ramipril (2.5-5 mg/day), paroxynephrine (10 mg/day), etc.  (6) Lipid-regulating therapy, commonly used drugs include lovastatin (20 mg/day), pravastatin (10 mg/day), simvastatin (20 mg/day), fluvastatin (20 mg/day), atorvastatin (10 mg/day), gemfibezil, niacin, etc.  (7) Chinese herbal medicines, commonly used are Brain Heart Tong, Guanxin Suhe Wan, Blood Activation and Pulse Tablets, Compound Danshen Tablets, etc.  (8) Other active drug treatment for hypertension, diabetes and other related diseases.  The condition of coronary heart disease is complex and each patient with coronary heart disease has its own characteristics. It is up to experienced doctors to decide how to choose medication. Treatment of coronary heart disease should be based on changes in dietary habits and lipid-regulating therapy, together with anti-platelet drugs, nitrates and beta-blockers to reduce symptoms, improve quality of life and prolong life expectancy.  Some patients need to undergo interventional or surgical treatment to improve their symptoms and survival rate. Long-term standard drug therapy must be adhered to after interventional treatment, so almost all patients with coronary artery disease should receive drug therapy. Generally speaking, drug therapy alone is suitable for patients with mild coronary artery disease who have mild clinical symptoms and less than 50% to 70% stenosis on coronary angiography in early stages, or patients with advanced and severe coronary artery disease who do not have the opportunity to receive surgical treatment due to the existence of contraindications to interventional or surgical bypass surgery.  In view of this, patients with suspected coronary artery disease need to go to a regular hospital for the appropriate examination to determine the treatment plan.