Guy's & St Thomas' Hospitals, NHS Trust, Cardiothoracic Centre, London, UK. lilian.crossley@gstt.sthames.nhs.uk
Many patients with stable angina pectoris are over-treated with haemodynamic agents. Understanding the different mode of action of the metabolic agent trimetazidine offers us the opportunity to implement effective combination therapy. Patients who fail to respond to optimal haemodynamic and metabolic therapy should be considered for a revascularisation procedure, not random additional drug therapy.