Treatment of Prinzmetal's Angina with Amlodipine

First-Line Therapies

• The American Heart Association recommends calcium channel blockers and nitrates as first-line therapies for patients with variant angina whose coronary angiogram shows no or nonobstructive coronary artery lesions 3
• First-line therapy for coronary spasm includes calcium channel blockers and nitrates, according to the American College of Cardiology 1, 2

Clinical Considerations

• The American Heart Association suggests that beta-blockers should generally be avoided in vasospastic angina due to their theoretical adverse potential 1
• Smoking cessation is essential as smoking is a risk factor for Prinzmetal's angina, as recommended by the American Heart Association 1
• For patients not responding completely to calcium channel blockers and nitrates, alpha-receptor blockers have been reported to be beneficial, according to the American Heart Association 1

Monitoring and Follow-up

• The American Heart Association recommends monitoring for resolution of anginal episodes and ST-segment changes on ECG 3
• Long-term therapy may be necessary despite symptom-free intervals, as Prinzmetal's angina often occurs in clusters with prolonged asymptomatic periods, according to the American Heart Association 5
• Patients with coronary artery vasospasm superimposed on fixed obstructive coronary artery disease have a worse prognosis and may require more aggressive therapy, as reported in Circulation 4