Evidence map›Paper›PMID 28880025›Full record

GuidelineNature reviews. Cardiology2018

Expert consensus document: A 'diamond' approach to personalized treatment of angina.

Roberto Ferrari, Paolo G Camici, Filippo Crea, Nicolas Danchin, Kim Fox, Aldo P Maggioni, Athanasios J Manolis, Mario Marzilli, Giuseppe M C Rosano, José L Lopez-Sendon

Abstract readPractice GuidelineReviewConsensus Statement
PubMed Publisher
In one paragraph

Guideline in Nature reviews. Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Review
  7. Review
  8. Review
  9. Article
  10. Contemporary Antianginal Therapy.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026
    Review
  11. Coronary artery spasm in cardiac arrest survivors.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Review
  12. Article
  13. Article
  14. Guideline for Chronic Coronary Syndrome - 2025.Arquivos brasileiros de cardiologia · 2025
    Article
  15. Review
  16. Article
  17. Article
  18. Review
  19. What has changed in the management of chronic ischaemic heart disease? The new European Society of Cardiology Guidelines 2024.European heart journal supplements : journal of the European Society of Cardiology · 2025
    Article
  20. Review

10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Roberto FerrariCentro Cardiologico Universitario, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Cona, Ferrara, Italy.
Paolo G CamiciVita Salute University and San Raffaele Hospital, Via Olgettina Milano, 58-60, 20132 Milan, Italy.
Filippo CreaDepartment of Cardiovascular and Thoracic Sciences, Catholic University, Largo Francesco Vito, 1, 00168 Rome, Italy.
Nicolas DanchinCardiology, European Hospital Georges-Pompidiou, 20 Rue Leblanc, 75015 Paris, France.
Kim FoxNational Heart and Lung Institute, Imperial College and Institute of Cardiovascular Medicine and Science, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
Aldo P MaggioniANMCO Research Center, Via A. La Marmora, 36, 50121 Florence, Italy.
Athanasios J ManolisDepartment of Cardiology, Asklepeion General Hospital, 1, Vas. Pavlou Street, 16673 Voula, Athens, Greece.
Mario MarzilliCardiothoracic Department, Lungarno Antonio Pacinotti, 43, 56126 Pisa, Italy.
Giuseppe M C RosanoClinical Academic Group, St George's Hospitals NHS Trust, Blackshaw Road, London SW17 0QT, UK.
José L Lopez-SendonCardiology Department, Hospital Universitario La Paz. IdiPaz, Paseo de la Castellana 261, Madrid 28036, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In clinical guidelines, drugs for symptomatic angina are classified as being first choice (β-blockers, calcium-channel blockers, short-acting nitrates) or second choice (ivabradine, nicorandil, ranolazine, trimetazidine), with the recommendation to reserve second-choice medications for patients who have contraindications to first-choice agents, do not tolerate them, or remain symptomatic. No direct comparisons between first-choice and second-choice treatments have demonstrated the superiority of one group of drugs over the other. Meta-analyses show that all antianginal drugs have similar efficacy in reducing symptoms, but provide no evidence for improvement in survival. The newer, second-choice drugs have more evidence-based clinical data that are more contemporary than is available for traditional first-choice drugs. Considering some drugs, but not others, to be first choice is, therefore, difficult. Moreover, double or triple therapy is often needed to control angina. Patients with angina can have several comorbidities, and symptoms can result from various underlying pathophysiologies. Some agents, in addition to having antianginal effects, have properties that could be useful depending on the comorbidities present and the mechanisms of angina, but the guidelines do not provide recommendations on the optimal combinations of drugs. In this Consensus Statement, we propose an individualized approach to angina treatment, which takes into consideration the patient, their comorbidities, and the underlying mechanism of disease.

Indexed as

Angina PectorisCardiologyCardiovascular AgentsClinical Decision-MakingComorbidityConsensusHumansPatient-Centered CarePatient SelectionRisk AssessmentRisk FactorsTreatment OutcomeCardiovascular Agents

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.