Metabolic management of ischaemic heart disease.

The present review summarizes the available information on the effects of the three major classes of antianginal agents (nitrates, calcium and beta-blockers) on myocardial energy metabolism. It also discusses the role of some new molecules (L-carnitine, trimetazidine and ranolazine) that have been proposed as an alternative pharmacological approach for the metabolic management of cardiac ischaemic syndromes.