Which therapy is effective for Prinzmetal variant angina?

• A. Calcium channel blockers or nitro
• B. Beta-blockers alone
• C. Thrombolytics
• D. Statins

Answer: (A)

Prinzmetal (variant) angina results from transient coronary vasospasm, so treatment focuses on preventing and relieving that spasm. Calcium channel blockers relax vascular smooth muscle and have proven to reduce the frequency and severity of these vasospastic episodes. Nitroglycerin provides rapid relief of spasm and can be used both acutely and chronically to prevent episodes. By contrast, beta-blockers can worsen vasospasm by leaving alpha-adrenergic vasoconstriction unopposed, and thrombolytics are aimed at clot dissolution in occlusive coronary events rather than vasospasm. Statins address cholesterol to reduce atherosclerotic risk but do not treat the vasospastic mechanism itself. Thus, calcium channel blockers or nitrates are the most effective therapy for Prinzmetal angina.