There are no data to show reduction of major cardiovascular events with use of these drugs- these agents should be used to alleviate symptoms.

Metabolic agents for treatment of angina:

• CPT inhibitors- includes amiodarone and perhexiline.
• FFAOX inhibitors- trimetazide and ranolazine.

Nicorandil is a K channel blocker with nitrate properties- it has been shown in the IONA study to reduce symptoms of angina.

Ivabradine is a new K channel blocker for treatment of angina that slows sinus rate.

Perhexiline has been shown to be effective is a small study for treatment of refractory angina but there is potential for toxicity. Perhexiline may be particularly effective in those with impaired LV systolic function.