Editing Antianginal (section)

== Political Considerations ==
The 2019 guidelines from the [[European Society of Cardiology|European Society of Cardiology (ESC)]] advocate for a personalized approach in which antianginal medications are tailored to an individual patient's comorbidities and hemodynamic profile. It's noteworthy that, although antianginal medications do not improve survival, their effectiveness in symptom reduction significantly depends on the underlying mechanism of angina.

Key considerations in antianginal therapies involve enhancing coronary vascular oxygen supply to the ischemic myocardium, reducing heart rate, myocardial work, and oxygen consumption, as well as optimizing the energetic efficiency of cardiomyocytes. Despite current guidelines recommending β-blockers and calcium-channel blockers as first-line therapy, there is a lack of evidence demonstrating their superiority over second-line therapies.

In this comprehensive review, it is crucial to emphasize that, thus far, neither drugs nor interventions that reduce ischemia have been shown to prolong survival in patients with chronic coronary syndromes.