Contemporary and Emerging Therapies in the Management of Refractory Angina: A Clinical Review

Refractory angina (RA) represents a growing challenge in clinical cardiology, particularly in patients with obstructive coronary artery disease (CAD) who remain symptomatic despite optimal medical therapy and who are not candidates for revascularization. Advances in both device-based and biologic therapies have introduced promising adjunctive strategies. This review critically appraises current and investigational treatment modalities for RA in order to give clinicians an informed up to date picture and to guide them with this difficult to treat population (Figure 1). Emphasis is placed on evaluating the safety profiles, therapeutic efficacy, and the strength of clinical evidence supporting each modality. This review aims to assist clinicians in individualized decision-making for RA management.