Boden博士介绍,稳定型心绞痛患者应在何时将治疗方案从药物治疗转变为血运重建术,目前尚不清楚。虽然并没有适合所有患者的方案,但许多专家认为,在判定OMT效果不佳前,所有患者(除外症状严重的患者)的初始疗程都应持续3-6个月。Sripal Bangalore博士表示,OMT持续3-6个月是非常合理的,但仍然应该以患者为中心,根据其病情和治疗意愿制定个体化的临床决策。对于年轻的心绞痛患者,抗心绞痛药物(尤其是β受体阻滞剂)引起的不良反应可能会明显降低其生活质量,血运重建可能是更好的选择。参考文献:1. Boden WE, Kaski JC, Al-Lamee R, et al. What constitutes an appropriate empirical trial of antianginal therapy in patients with stable angina before referral for revascularisation? Lancet. 2022 Feb 12; 399(10325): 691-694. 2. Michael O'Riordan. Optimal Medical Therapy for Stable Angina: Which Drugs? How Long? tctMD. JANUARY 25, 2022.3. Ferrari R, Camici PG, Crea F, et al. Expert consensus document: A 'diamond' approach to personalized treatment of angina. Nat Rev Cardiol. 2018 Feb; 15(2): 120-132.