Metabolic agents such as perhexiline, trimetazidine, ranolazine, and etomoxir offer alternative treatment options for patients with refractory chronic angina pectoris.
Potential role for metabolic agents in refractory angina remains hypothesis-generating; prospective trials needed before practice change.
The ever-increasing burden of ischaemic heart disease and its common manifestation chronic angina pectoris calls for the exploration of other treatment options for those patients who despite the maximum conventional pharmacological and surgical interventions continue to suffer. Such exploration has led to the increasing use of new metabolically acting antianginal agents and the re-emergence of an old and somewhat forgotten pharmacological agent, perhexiline maleate. This review aims to update the cardiac nurse with knowledge to manage the care a patient receiving perhexiline maleate treatment and provide a brief review of three new metabolic agents: trimetazidine, ranolazine and etomoxir.
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Inglis et al. (2006) studied this question.
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