Yale University
To establish the effectiveness and tolerability of standard of care anti-anginal treatment (beta-blocker and calcium channel blocker medications) in older adults with symptomatic Stable Ischemic Heart Disease (SIHD) and multiple chronic conditions (MCC).
Single-blind, randomized (1:1) pragmatic trial comparing Beta-Blocker therapy versus Calcium Channel Blocker therapy in older adults with symptomatic SIHD and MCC with plans to initiate medical treatment with anti-anginal therapy. Study Aims Aim 1: To compare the effectiveness of anti-anginal medications to improve the symptoms, function, and quality of life among older adults with multiple chronic conditions presenting with stable angina. Aim 2: To compare the tolerability and safety of commonly used anti-anginal medications in older adults with multiple chronic conditions presenting with st…
Inclusion Criteria: OLDER ADULTS WITH SIHD AND MCC * Age ≥65 years * ≥ 2 Multiple Chronic Conditions as defined by Centers for Medicare and Medicaid Services (CMS) * Diagnosis of Symptomatic Stable Ischemic Heart Disease with plans to initiate medical therapy identified by at least one of the following: 1. positive non-invasive functional or anatomic testing suggestive of obstructive coronary artery disease 2. coronary angiography with stenosis ≥70% in a coronary artery ≥2 mm in diameter or ≥50% stenosis of left main 3. Invasive coronary angiography with positive physiologic tes…
Clinician discretion as to which BB or CCB will be used if the participant has a heart rate and blood pressure within normal limits.
Selection of the specific BB and initial starting dose will be determined by the treating clinician.
Selection of the specific CCB and initial starting dose will be determined by the treating clinician.