Why this is important We do not know the long-term clinical and cost effectiveness of adding a newer anti- anginal drug to a calcium channel blocker in people with stable angina. We propose a double-blind placebo-controlled randomised trial comparing the addition of a newer anti- anginal drug to a calcium channel blocker with a calcium channel blocker alone in people with stable angina whose symptoms are not being controlled. Endpoints would include symptom severity, quality of life, long-term morbidity and mortality, and cost effectiveness. The results of the trial would influence clinical practice and inform future updates of key recommendations in this guideline. 2 Management of stable angina in people with evidence of ischaemia on non-invasive functional testing Do people with stable angina and evidence of reversible ischaemia on non-invasive functional testing who are on optimal drug treatment benefit from routine coronary angiography with a view to revascularisation? Why this is important Revascularisation has traditionally been offered to people with stable angina who have evidence of reversible ischaemia on non-invasive functional testing. Recent trials in people with stable angina (COURAGE, BARI-2D, MASS II) have not shown survival benefit from revascularisation compared with drug treatment. In the nuclear substudy of COURAGE (n = 314), PCI was shown to be more effective in treating ischaemia than optimal drug treatment, and in multivariate analyses reduction of ischaemia was associated with greater event-free survival. It is unclear, however, whether people on optimal drug treatment who have evidence of inducible ischaemia on non-invasive functional testing should routinely have coronary angiography and revascularisation. This question is particularly relevant for people who have responded adequately (for example Canadian Cardiovascular Class 1 or 2) to optimal drug treatment and in whom, based on symptoms alone, revascularisation is not indicated. 