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En stabil angina pectoris er en tilstand man kan leve med over mange år.
En stabil angina pectoris er en tilstand man kan leve med over mange år.

Angina pectoris, inndeling

Det er vanlig å dele angina (hjertekrampe) inn i det vi kaller "stabil" angina pectoris og "ustabil" angina pectoris.

Sist revidert:

Del pasientinformasjon

Den ligger åpent tilgjengelig på NHI.no sammen annen relevant informasjon


Inndeling av angina

Stabil angina

Ustabil angina

Tegn på at en stabil angina har blitt ustabil

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Dette dokumentet er basert på det profesjonelle dokumentet Angina pectoris, stabil. Referanselisten for dette dokumentet vises nedenfor.

  1. Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J 2019. doi:10.1093/eurheartj/ehz425 DOI 
  2. Schef KW, Tornvall P, Alfredsson J, et al. Prevalence of angina pectoris and association with coronary atherosclerosis in a general population. Heart 2023. pmid:37225242 PubMed 
  3. Folkehelseinstituttet. Hjerte- og karregisteret. Diagnoser 2018. statistikkbank.fhi.no 
  4. Schoenhagen P, Ziada RM, Kapadia SP, Crowe TD, Nissen SE, Tuzcu EM. Extent and direction of arterial remodeling in stable versus unstable coronary syndromes: an intravascular ultrasound study. Circulation 2000; 101: 598-603. Circulation 
  5. Halcox JP, Schenke WH, Zalos G, et al. Prognostic value of coronary vascular endothelial dysfunction. Circulation 2002; 106: 653-8. Circulation 
  6. Opie LH, Commerford PJ, Bersh BJ. Controversies in stable coronary artery disease. Lancet 2006; 367: 69-78. PubMed 
  7. Kaski JC. Pathophysiology and management of patients with chest pain and normal coronary arteriograms (cardiac syndrome X). Circulation 2004; 109: 568-72. Circulation 
  8. Gotto AM jr., LaRosa JC, Hunninghake D, Grundy SM, Wilson PW, Clarkson TB et al. The cholesterol facts. A summary of the evidence relating dietary fats, serum cholesterol, and coronary heart disease. A joint statement by the American Heart Association and the National Heart, Lung and Blood Institute. Circulation 1990; 81: 1721-33. Circulation 
  9. Lakka H-M, Lakka TA, Tuomilehto J, Salonen JT. Abdominal obesity is associated with increased risk of acute coronar events in men. Eur Heart J 2002; 23: 706-13. PubMed 
  10. Rosengren A, Hawken S, Ôunpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364: 953-62. PubMed 
  11. Bogers RP, Bemelmans WJ, Hoogenveen RT, et al. Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: A meta-analysis of 21 cohort studies including more than 300 000 persons. Arch Intern Med 2007; 167: 1720-8. PubMed 
  12. Yusuf S, Hawken S, Ôunpuu S et al. Obesity and the risk of myocardial infarction in 27 000 participants from 52 countries: a case-control study. Lancet 2005; 366: 1640-9. PubMed 
  13. Smith JK, Dykes R, Douglas JE, Krishnaswamy G, Berk S. Long-term Exercise and Atherogenic Activity og Blood Mononuclear Cells inPersons at Risk of Developing Ischemic Heart Disease. JAMA 1999; 281:1722-1727. Journal of the American Medical Association 
  14. Hemingway H, Marmot M. Psychosocial factors in the primary and secondary prevention of coronary heart disease: a systematic review. I: Yusuf S, Cairns JA, Camm AJ, Fallen EL, Gersh BJ, red. Evidence based cardiology. London: BMJ Books, 1998: 269-85.
  15. Tirosh A, Shai I, Tekes-Manova D et al. Normal fasting plasma glucose levels and type 2 diabetes in young men. N Engl J Med 2005; 353: 1454-62. New England Journal of Medicine 
  16. Sattar N, Gaw A, Scherbakova O, et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003; 108: 414-9. Circulation 
  17. Prior JO, Quinones MJ, Hernandez-Pampaloni M, et al. Coronary circulatory dysfunction in insulin resistance, impaired glucose tolerance, and type 2 diabetes mellitus. Circulation 2005; 111: 2291-8. Circulation 
  18. Fan C, Wang H, Gu Y. Recurrent Angina After Alcohol Consumption. JAMA Intern Med 2023. doi:10.1001/jamainternmed.2022.5411 DOI 
  19. Bello N, Mosca L. Epidemiology of coronary heart disease in women. Prog Cardiovasc Dis 2004; 46: 287-95. PubMed 
  20. Bugiardini R, Bairey Merz CN. Angina with "normal" coronary arteries: a changing philosophy. JAMA 2005; 293: 477-84. Journal of the American Medical Association 
  21. Abrams J. Chronic stable angina. N Engl J Med 2005; 352: 2524-33. PubMed 
  22. Sekhri N, Feder GS, Junghans C, et al. Incremental prognostic value of the exercise electrocardiogram in the initial assessment of patients with suspected angina: cohort study. BMJ 2008; 337: a2240. BMJ (DOI) 
  23. Maffei E, Seitun S, Martini C, et al. CT coronary angiography and exercise ECG in a population with chest pain and low-to-intermediate pre-test likelihood of coronary artery disease. Heart 2010; 96: 1973-9. PubMed 
  24. Boden WE, O'Rourke RA, Teo KK, et al, for the COURAGE Trial Research Group. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007; 356: 1503-16. New England Journal of Medicine 
  25. The DISCHARGE Trial Group. CT or Invasive Coronary Angiography in Stable Chest Pain. N Engl J Med 2022. pmid:35240010 PubMed 
  26. Klocke FJ, Baird MG, Lorell BH, et al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging -- executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). Circulation 2003; 108: 1404-18. Circulation 
  27. Papachristidis A, Vaughan GF, Denny SJ, et al. Comparison of NICE and ESC proposed strategies on new onset chest pain and the contemporary clinical utility of pretest probability risk score. Open Heart. 2020 May;7(1):e001081. doi: 10.1136/openhrt-2019-001081. PMID: 32467136. PubMed 
  28. US Preventive Services Task Force. Screening for Cardiovascular Disease Risk With Electrocardiography. US Preventive Services Task Force Recommendation Statement. JAMA 2018; 319: 2308-14. pmid: 29896632 PubMed 
  29. Frye RL, August P, Brooks MM, et al. BARI 2D study group. A randomized trial of terapies for type 2 diabetes and coronary arterry disease. N Engl J Med 2009; 360: 2503-15. New England Journal of Medicine 
  30. Wijeysundera HC, Nallamothu BK, Krumholz HM, et al. Meta-analysis: Effects of percutaneous coronary intervention versus medical therapy on angina relief. Ann Intern Med 2010; 152: 370-9. Annals of Internal Medicine 
  31. Maron DJ, Hochman JS, Reynolds HR, et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med 2020; 382: 1395-407. pmid:32227755 PubMed 
  32. Trikalinos TA, Alsheikh-Ali AA; Tatsioni A, et al. Percutaneous coronary interventions for non-acute coronary artery disease: quantitative 20-year synopsis and a network meta-analysis. Lancet 2009; 373: 911-8. PubMed 
  33. Sipahi I, Akay MH, Dagdelen S, et al. Coronary artery bypass grafting vs percutaneous coronary intervention and long-term mortality and morbidity in multivessel disease. Metaanalysis of randomized clinical trials of the arterial grafting and stenting era. JAMA 2013. doi:10.1001/jamainternmed.2013.12844 DOI 
  34. Head SJ, Milojevic M, Daemen J, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. Lancet 2018; 391: 939. pmid:29478841 PubMed 
  35. Head SJ, Milojevic M, Daemen J, et al. Stroke Rates Following Surgical Versus Percutaneous Coronary Revascularization. J Am Coll Cardiol 2018; 72: 386. pmid:30025574 PubMed 
  36. Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD000165. DOI: 10.1002/14651858.CD000165.pub4. DOI 
  37. Barnoya J and Glantz SA. Cardiovascular effects of secondhand smoke: nearly as large as smoking. Circulation 2005; 111: 2684-98. Circulation 
  38. Weitzman M, Cook S, Auinger P, et al. Tobacco smoke exposure is associated with the metabolic syndrome in adolescents. Circulation 2005; 112: 862-9. Circulation 
  39. Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, Davey Smith G. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD002137. DOI: 10.1002/14651858.CD002137.pub3. DOI 
  40. Heidenreich PA, McDonald KM et al. Meta-analysis of trials comparing beta-blockers, calcium antagonists, and nitrates for stable angina. A systematic review. JAMA 1999; 281: 1927-36. Journal of the American Medical Association 
  41. Gibbons RJ, Abrams J, Chatterjee K, et al. ACC/AHA 2002 guideline update for the management of patients with chronic stable angina -- summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Chronic Stable Angina). J Am Coll Cardiol 2003; 41: 159-68. PubMed 
  42. Salpeter SR, Ormiston TM, Salpeter EE, Wood-Baker R. Cardioselective beta-blockers for reversible airway disease. Cochrane Database of Systematic Reviews 2002, Issue 4. Art. No.: CD002992. DOI: 10.1002/14651858.CD002992. DOI 
  43. Sabatine MS, Giugliano RP, Keech AC, et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 2017. pmid:28304224 PubMed 
  44. Shin E-S, Lee J-H, Yoo S-Y, et al. A randomised, multicentre, double blind, placebo controlled trial to evaluate the efficacy and safety of cilostazol in patients with vasospastic angain. Heart 2014. doi:10.1136/heartjnl-2014-305986 DOI 
  45. Colhoun HM, Betteridge DJ, Durrington PN, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet 2004; 364: 685-96. PubMed 
  46. LaRosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005; 352: 1425-35. New England Journal of Medicine 
  47. Bangalore S, Fakheri R, Wandel S, et al. Renin angiotensin system inhibitors for patients with stable coronary artery disease without heart failure: Systematic review and meta-analysis of randomized trials. BMJ 2017; doi: 10.1136/bmj.j4 DOI 
  48. Nidorf SM, Fiolet ATL, Mosterd A, et al. Colchicine in Patients with Chronic Coronary Disease. N Engl J Med. 2020 Aug 31. PMID: 32865380 PubMed 
  49. Salazar CA, Basilio Flores JE, Veramendi Espinoza LE, et al. Ranolazine for stable angina pectoris. Cochrane Database Syst Rev. 2017 Feb 8;2:CD011747. doi: 10.1002/14651858.CD011747.pub2. (Review) PMID: 28178363 PubMed 
  50. Maagaard M, Nielsen EE, Sethi NJ, et al. Effects of adding ivabradine to usual care in patients with angina pectoris: a systematic review of randomised clinical trials with meta-analysis and Trial Sequential Analysis. Open Heart 2020. pmid:33046592 PubMed 
  51. Al-Lamee RA, Nowbar AN, Francis DP. Percutaneous coronary intervention for stable coronary artery disease. Heart 2019; 105: 11-19. doi:10.1136/heartjnl-2017-312755 DOI 
  52. Lied A, Morstøl TH, Vik-Mo H. Koronar angioplastikk hos eldre pasientar. Tidsskr Nor Lægeforen 2002; 122: 1266-9. PubMed 
  53. Mohr FW, Morice M-C, Kappetein AP, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet 2013; 381: 629-38. pmid:23439102 PubMed 
  54. Thuijs DJFM, Kappetein AP, Serruys PW, et al. Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial. Lancet 2019. pmid:31488373 PubMed 
  55. American College of Cardiology and American Heart Association. Guidelines for coronary artery bypass graft surgery: Executive summary and recommendations. Circulation 1999; 100: 1464-80. PubMed 
  56. Clar C, Oseni Z, Flowers N, Keshtkar‐Jahromi M, Rees K. Influenza vaccines for preventing cardiovascular disease. Cochrane Database of Systematic Reviews 2015, Issue 5. Art. No.: CD005050. DOI: 10.1002/14651858.CD005050.pub3. Accessed 01 February 2022. The Cochrane Library 
  57. Udell JA, Zawi R, Bhatt DL, et al. Association between influenza vaccination and cardiovascular outcomes in high-risk patients: a meta-analysis. JAMA 2013 Oct 23;310(16):1711-20. PubMed 
  58. Long L, Anderson L, Dewhirst AM, He J, Bridges C, Gandhi M, Taylor RS. Exercise‐based cardiac rehabilitation for adults with stable angina. Cochrane Database of Systematic Reviews 2018, Issue 2. Art. No.: CD012786. DOI: 10.1002/14651858.CD012786.pub2. Accessed 01 February 2022. The Cochrane Library 
  59. Dibben G, Faulkner J, Oldridge N, Rees K, Thompson DR, Zwisler A-D, Taylor RS. Exercise‐based cardiac rehabilitation for coronary heart disease. Cochrane Database of Systematic Reviews 2021, Issue 11. Art. No.: CD001800. DOI: 10.1002/14651858.CD001800.pub4. Accessed 01 February 2022. The Cochrane Library 
  60. Gaudino M, Chadow D, Rahouma M, et al. Operative Outcomes of Women Undergoing Coronary Artery Bypass Surgery in the US, 2011 to 2020. JAMA Surg 2023. pmid:36857059 PubMed 
  61. Noman A, Ang DSC, Ogston S, et al. Effect of high-dose allopurinol on exercise in patients with chronic stable angina: a randomised, placebo controlled crossover trial. Lancet 2010; 375: 2161-7. PubMed 
  62. Kappetein AP, Feldman TE, Mack MJ, et al. Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease: 3-year follow-up of the SYNTAX trial. Eur Heart J 2011; 32: 2125-34. pmid:21697170 PubMed