Since this guidance was produced, the Medicines and Healthcare products Regulatory Agency (MHRA) have published new advice about safety concerns related to ivabradine (June 2014 and December 2014) and nicorandil (January 2016). When combining ivabradine with a calcium channel blocker, use a dihydropyridine calcium channel blocker, for example, slow release nifedipine, amlodipine, or felodipine. 1.4.13 Do not offer a third anti-anginal drug to people whose stable angina is controlled with two anti-anginal drugs. 1.4.14 Consider adding a third anti-anginal drug only when: the person's symptoms are not satisfactorily controlled with two anti-anginal drugs and the person is waiting for revascularisation or revascularisation is not considered appropriate or acceptable. Decide which drug to use based on comorbidities, contraindications, the person's preference and drug costs. 1.5 Investigation and revascularisation People with stable angina whose symptoms are not satisfactorily controlled with optimal medical treatment 1.5.1 Consider revascularisation (coronary artery bypass graft [CABG] or percutaneous coronary intervention [PCI]) for people with stable angina whose symptoms are not satisfactorily controlled with optimal medical treatment. 1.5.2 Offer coronary angiography to guide treatment strategy for people with stable angina whose symptoms are not satisfactorily controlled with optimal medical treatment. Additional non-invasive or invasive functional testing may be required to evaluate angiographic findings and guide treatment decisions. [This recommendation partially updates recommendation 1.2 of the NICE technology appraisal guidance on myocardial perfusion scintigraphy for the diagnosis and management of angina and myocardial infarction.] 1.5.3 Offer CABG to people with stable angina and suitable coronary anatomy when: their symptoms are not satisfactorily controlled with optimal medical treatment and revascularisation is considered appropriate and PCI is not appropriate. 