Title : Current approaches to anti-angina drug treatment in Chronic-stable Angina Pectoris (CSAP) in US primary care and cardiology – A cross-sectional, blinded standard-of-care survey
Abstract:
Background: Availability and use recommendations of anti-anginals in chronic-stable angina pectoris (CSAP) has changed little since the last anti-anginal was FDA approved in 2006. Recent large outcomes studies have changed consensus on management of CSAP. Guidelines again focus on drug treatment for most pts. With new anti-anginals in development it seems prudent to investigate management approaches to CSAP in primary care and cardiology.
Methods: Perceived disease burden, similarities & differences in treatment with available anti- angina drug portfolio and impact of select comorbid conditions was studied comparing 30 cardiology (CARD) vs 30 internal medicine (IM) participants (demographics: Fig.1). Eligible participants were board-certified, actively managing CSAP patients (caseload ≥30 and ≥25 pts.). The survey comprised 30 questions assessing demographics, patient characteristics, diagnostic approaches, and treatment initiation & maintenance patterns. Responses were anonymized and collected between Jul and Aug 2025. Evaluable information was available for all 60 physicians.
Results: Baseline patient demographic data confirms representative patient pool: 56% male, estimated age 60-70y for most (65%), and weekly angina symptoms in 45% of pts. For key survey output data see Fig. 1.
Conclusion: There is agreement between CARDs and IMs on treatment goals, utility of antianginals, assessment and core drivers of refractory angina, impact of CMD as a comorbidity and its treatment- complicating effect. Treatment initiation with 2 antianginals is common despite UIS guideline recommendations to the contrary. Differences exist between antianginal drug choices and comorbidity prevalence estimates.
