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May 2020 Br J Cardiol 2020;27:60–3 doi:10.5837/bjc.2020.012

A multi-disciplinary care pathway improves symptoms, QoL and medication use in refractory angina

Kevin Cheng, Ranil de Silva

Abstract

Introduction Refractory angina (RA) is an increasingly common clinical problem due to improved survival from coronary artery disease (CAD) and an ageing population. It is defined as chronic angina-type chest pain (≥3 months in duration) due to myocardial ischaemia in the setting of CAD that persists despite optimal medical therapy, angioplasty or bypass surgery. In the US, between 600,000 and 1.8 million people are living with RA.1,2 Annually, it is estimated that 75,000 new cases are diagnosed in the US and 30,000 to 50,000 in Europe. Long-term outcomes are better than previously estimated (nine-year life expectancy is 71.6%).3 With persis

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