Recurrent angina after percutaneous or surgical coronary procedures may occur as a consequence of several potential causes, such as bypass graft failure, restenosis, or atherosclerotic disease progression. Repeat invasive procedures are frequently performed for patients with recurrent symptoms. Nevertheless, non-invasive pharmacological treatment to decrease disease progression or reduce anginal symptoms are an integral part of the management of the patients. New metabolic modulators such as trimetazidine may constitute important therapeutic agents in the symptomatic control of patients with recurrent angina after invasive revascularization.