What is the drug of choice for unstable angina?

Unstable angina is a disease that is very harmful to the human body. Therefore, when unstable angina occurs, you must actively seek treatment and pay more attention to diet in daily life. You should develop good living habits and eating habits, exercise more, and eat more foods with high protein content for unstable angina. This is conducive to the recovery of the disease. So what is the first choice medicine for unstable angina?

Aspirin and heparin are important treatments for unstable angina, which aim to prevent thrombosis and stop the disease from developing into myocardial infarction. Hospitals with the conditions should perform emergency coronary angiography and intervention or elective coronary angiography and intervention.

Preventive measures for unstable angina

Primary prevention measures

(1) Health education: Provide health knowledge education to the entire population, improve citizens' self-care awareness, avoid or change bad living habits, such as quitting smoking, paying attention to a proper diet, exercising appropriately, maintaining psychological balance, etc., so as to reduce the occurrence of coronary heart disease.

(2) Control high-risk factors: Actively treat high-risk groups for coronary heart disease, such as those with hypertension, diabetes, hyperlipidemia, obesity, smoking, and family history. Of course, some of these risk factors can be controlled, such as high blood pressure, high blood lipids, diabetes, obesity, smoking, and an inactive lifestyle; while some cannot be changed, such as family history of coronary heart disease, age, and gender. Treatment methods include using appropriate medications to continuously control blood pressure, correcting abnormal lipid metabolism, quitting smoking and limiting alcohol, appropriate physical activity, controlling weight, and controlling diabetes.

Secondary prevention

Use proven effective drugs to prevent the recurrence and aggravation of coronary heart disease. The drugs that have been confirmed to have preventive effects include:

(1) Antiplatelet drugs: Aspirin has been shown to reduce the incidence of myocardial infarction and the rate of reinfarction. The use of aspirin after acute myocardial infarction can reduce the rate of reinfarction by approximately 25%. If aspirin is intolerant or allergic, clopidogrel can be used.

(2) β-blockers: As long as there are no contraindications, patients with coronary heart disease should use β-blockers, especially after an acute coronary event. Data show that the use of β-blockers in patients after acute myocardial infarction can reduce the mortality rate and reinfarction rate by 20% to 25%. The drugs that can be used include metoprolol, propranolol, timolol, etc.

(3) Statins: Research results show that long-term lipid-lowering treatment for patients with coronary heart disease not only reduces the overall mortality rate and improves the survival rate, but also reduces the number of patients requiring coronary intervention or CABC. This is due to the fact that in addition to its lipid-lowering effects, statins also have the ability to improve endothelial function, have anti-inflammatory effects, affect smooth muscle cell proliferation, and interfere with platelet aggregation, coagulation, and fibrinolysis. Simvastatin, pravastatin, clovastatin and atorvastatin all have this effect.

(4) ACEI: mostly used in patients with severe left ventricular dysfunction or heart failure. Many clinical trial results have confirmed that ACEI reduces mortality after acute myocardial infarction; therefore, after acute myocardial infarction, patients with ejection fraction <40% or wall motion index ≤1.2 and no contraindications should use ACEI. Commonly used ones include captopril, enalapril, benazepril and fosinopril.