Pharmacotherapy STABLE coronary artery disease

2. Anti-ischemic agents  to relief symptoms & improve quality of life

Anti-ischemic agents
1. The first line & the ONLY ischemic therapy to reduce angina symptoms
2. ALL BB are equally effective in treating stable CAD (nebivolol not study to treat MI and angina)
3. BB* had reduce ALL-CAUSE mortality in pt having HF with reduced LV function
BB*: had improve prognosis & better CV outcome:
 Carvedilol
1. S/E: 2. C/I:
 Bisoprolol
 LA metaprolol  Hypotension  Conduction disorder
1. Beta blocker

 Nebivolol  Fatigue  Cardiaogenic shock

 Bardycardia 3. Caution:
4. Nebivolol (B1 selective blocker):  Heart block  Asthma
 Improve insulin sensitivity  Bronchospasm 4. Choosing agents depend on
 & Do no deleterious (harm) effect on lipid profile  Peripheral  Cost
5. Carvedilol (non-selective B blocker and selective A1 blocker): vasoconstriction  Daily dose
 Maintain glycemic control  Impotence  Co-morbid
 Improve insulin sensitivity  Hypoglycaemia
 Depression
6. However, continue BB after 1 yr does not reduce long term mortality