Researchers are trying to define more clearly which treatment plans are most effective in patients with unstable angina and other coronary syndromes. For example, some researchers favor a "routine early invasive" strategy, described as cardiac catheterization (with an angiogram) and catheter-based procedures within 24 to 48 hours after the episode.

Antiplatelet therapy (e.g., aspirin plus clopidogrel) is also administered. This approach maintains that appropriate therapy can best suit the patient once an angiogram is performed. Others propose a "selective invasive" strategy, which involves drug management first (e.g., antiplatelets, ischemia medications) along with exercise stress testing and nuclear or other imaging techniques.

An angiogram is performed when deemed necessary, followed by revascularization if needed. "Early" and "selective" strategies are also influenced by how high (or low) a patient’s risk is for heart attack or heart failure. Researchers have also found that B-natriuretic peptide (BNP) levels can reflect or correlate with the risk of heart failure and death in patients with unstable angina. BNP is produced in the heart muscle and released in response to stresses put on the walls of the ventricles (the heart's lower chambers).

Researchers had already known that elevated BNP levels were associated with increased mortality in persons sustaining a heart attack and in those with heart failure. BNP measurements may be yet another useful tool in identifying high-risk (or low-risk) patients and, thereafter, tailoring the most effective treatment strategy for them.

Researchers have also observed that C-reactive protein (CRP), a “marker” of inflammation, can help identify angina patients who are at higher risk for developing a heart attack. Additional studies are focusing on advances in the diagnosis, treatment and prevention of conditions associated with angina:

• Noninvasive methods for diagnosing coronary artery stenosis
  
• New drug treatments
  
• Spinal cord stimulation
  
• Stem cell research for heart disease
  
• Hormone and angina relationship
  
• Cardiac rehabilitation for angina treatment
  
• Inflammatory markers for heart disease
  
• Timing of treatment

Researchers are studying whether gene therapy can create blood vessels in the heart to improve the blood supply and relieve angina. Early studies have suggested this approach might help women but not men. In 2007 a follow-up study began enrolling women at 50 medical centers in the United States.