Symptomatic treatment after ACS
Anti-anginal therapy in patients after acute coronary syndrome: evaluation of newer agents

Coronary heart disease (CAD) is the leading cause of death worldwide. Many patients who survive an acute myocardial infarction will experience recurrent angina which significantly impairs quality of life and in severe cases is associated with increased mortality. Angina occurs when there is a mismatch between coronary supply and demand. Traditional agents including b-blockers, calcium-channel blockers and nitrates exert their effect by reducing the hemodynamic components of myocardial oxygen demand such as heart rate, blood pressure and preload. After several decades without new therapies in our pharmacologic armamentarium, several promising new agents have undergone clinical evaluation with promising results. Some of these novel agents exert their anti-anginal effects through reduction in traditional hemodynamic parameters but others target novel steps in the ischemic pathway. This review examines the pharmacologic management of angina in patients after acute coronary syndrome (ACS) with a focus on novel agents.