Q. I am a 75-year-old black man with coronary artery disease, including two heart attacks and two bypass surgeries in my 40s and 50s. I am on several heart medications (including statins and his PCSK9 inhibitor), but I still frequently experience chest pain when walking, especially when going up stairs. My LDL cholesterol is 61 and my triglycerides are 43. Are there other treatments that can shrink atherosclerotic plaques? My doctor said I am not a candidate for a stent.

A. You may be relieved to know that angina (chest pain associated with exertion or emotional stress) is very common among people with coronary artery disease. Your symptoms seem pretty serious, which is not surprising considering your history of heart disease. Good news? There are several other options you can pursue to relieve your angina.

Even if your doctor says a stent isn’t an option, you may want to get a second opinion on whether this surgery is viable for you. In complex situations like yours, a second opinion is often helpful.

In addition, there are many other medications that can be tried, which fall into two broad strategies. One, as you pointed out, is to shrink the plaque in the arteries. Although your current LDL levels are good, lowering them further may help. Another cholesterol-lowering drug, ezetimibe (Zetia) or bempedoic acid (Necletol), may also be added to your current medication. Another drug, icosapent ethyl (Vasepa), has also been shown to reduce plaque, but only in people with high triglycerides (more than 150 milligrams per deciliter). Triglycerides are normal, so it’s not clear if this helps.

There are other medications that can help reduce the frequency and severity of symptoms. For example, the calcium channel blocker diltiazem (Cardizem) slows the heart rate (ideally to about 60 beats per minute), and long-acting nitrates such as isosorbide (Isoldil) help dilate the coronary arteries. If your heart rate and blood pressure are already well controlled, you can add another drug called ranolazine (Ranexa), which affects the metabolism of heart cells.

Finally, ask your doctor about colchicine (Rodoco). This anti-inflammatory drug has long been used to treat a type of arthritis called gout. However, lower doses have been shown to prevent heart attacks in people with coronary artery disease.

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