Coronary artery disease is common, affecting more than an estimated 125 million people worlwide [1,2]. More than half of all patients with coronary artery disease (CAD) have anginal symptoms [3]. Medical therapy, in conjunction with lifestyle changes, is the recommended first line intervention for all patients with stable coronary artery disease [4,5]. Optimal medical therapy (OMT) as defined in the guidelines and most major trials has been a combination of medications aimed at reducing cardiac events and anginal symptoms.