1. Management of Patients With Refractory Angina: Canadian Cardiovascular Society/Canadian Pain Society Joint Guidelines
- Author
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Michael, McGillion, Heather M, Arthur, Allison, Cook, Sandra L, Carroll, J Charles, Victor, Philippe L, L'allier, E Marc, Jolicoeur, Nelson, Svorkdal, Joel, Niznick, Kevin, Teoh, Tammy, Cosman, Barry, Sessle, Judy, Watt-Watson, Alexander, Clark, Paul, Taenzer, Peter, Coyte, Louise, Malysh, Carol, Galte, James, Stone, and Lynn, Cooper
- Subjects
Canada ,Safety Management ,medicine.medical_specialty ,Psychological intervention ,Disease ,Angina Pectoris ,Coronary artery disease ,Quality of life (healthcare) ,Meta-Analysis as Topic ,Sickness Impact Profile ,Activities of Daily Living ,Health care ,Myocardial Revascularization ,Secondary Prevention ,medicine ,Humans ,Disease management (health) ,Intensive care medicine ,Societies, Medical ,Quality Indicators, Health Care ,Patient Care Team ,business.industry ,Mortality rate ,Disease Management ,Cardiovascular Agents ,Canadian Cardiovascular Society ,medicine.disease ,Pain, Intractable ,Self Care ,Outcome and Process Assessment, Health Care ,surgical procedures, operative ,Physical therapy ,Cardiology and Cardiovascular Medicine ,business ,Stress, Psychological - Abstract
Refractory angina (RFA) is a debilitating disease characterized by cardiac pain resistant to conventional treatments for coronary artery disease including nitrates, calcium-channel and β-adrenoceptor blockade, vasculoprotective agents, percutaneous coronary interventions, and coronary artery bypass grafting. The mortality rate of patients living with RFA is not known but is thought to be in the range of approximately 3%. These individuals suffer severely impaired health-related quality of life with recurrent and sustained pain, poor general health status, psychological distress, impaired role functioning, and activity restriction. Effective care for RFA sufferers in Canada is critically underdeveloped. These guidelines are predicated upon a 2009 Canadian Cardiovascular Society (CCS) Position Statement which identified that underlying the problem of RFA management is the lack of a formalized, coordinated, interprofessional strategy between the cardiovascular and pain science/clinical communities. The guidelines are therefore a joint initiative of the CCS and the Canadian Pain Society (CPS) and make practice recommendations about treatment options for RFA that are based on the best available evidence. Concluding summary recommendations are also made, giving direction to future clinical practice and research on RFA management in Canada.
- Published
- 2012
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