Blood-thinning medications: The so-called anticoagulants, also called platelet aggregation inhibitors (e.g., Aspirin, Plavix, Brilique or Efient), act on the blood platelets (thrombocytes) and thus inhibit blood clotting. They thus reduce the risk of blood clots (thrombi) forming in the coronary arteries, which can block the coronary arteries and thus lead to a heart attack. However, anticoagulants are also particularly important after surgery, when a stent has been inserted into the coronary arteries. They then protect the coronary vessel from acute occlusion, which could have serious consequences.
Beta-receptor blockers: Beta-blockers inhibit the action of stress hormones. They ensure that blood pressure is lowered and the heart beats more slowly. As a result, oxygen consumption by the heart muscle decreases. Angina pectoris symptoms are thus alleviated. In heart attack patients, beta-blockers can reduce the risk of developing secondary diseases or dying from vascular disease.
Nitrates and calcium antagonists: Nitrates and calcium antagonists have a vasodilatory effect. On the one hand, this improves blood flow to the heart and supplies it with oxygen; on the other hand, they slow down the flow of blood from the body to the heart. The heart thus has to pump less and its oxygen consumption decreases. Nitrates can quickly relieve symptoms of acute angina pectoris attacks.
Cholesterol-lowering agents: Excessive cholesterol levels promote the development and progression of arteriosclerosis. To control elevated blood lipid levels, we usually prescribe statins. A recently published study showed that the commonly described side effects of statins, such as muscle pain, are rare. Even if your blood lipid levels are normal, these medications have a positive effect on the progression of your coronary artery disease and should therefore be taken if you already have established coronary artery disease.
Furthermore, there are other medications available (e.g. ranolazine, nicorandil or ivabradine) which can be used in special situations. They are mainly used if certain reasons speak against taking first-line drugs or if they do not have the desired effect.