Which treatment option should be avoided for a patient with diabetic Prinzmetal angina?

In the context of diabetic Prinzmetal angina, β-blockers should be avoided due to their potential to cause vasoconstriction of coronary arteries. Prinzmetal angina is characterized by episodes of chest pain due to transient vasospasm of coronary vessels, and in patients who also have diabetes, the risk of exacerbating these spasms is a significant concern.

β-blockers can inhibit β2 adrenergic receptor activity, which plays a role in vasodilation. Therefore, using β-blockers in a condition like Prinzmetal angina can counteract the desired vasodilatory effects and possibly worsen the patient’s condition by promoting further episodes of angina.

In contrast, calcium channel blockers and nitrates are actually beneficial for treating Prinzmetal angina, as they promote relaxation and vasodilation of the coronary arteries, helping to alleviate the angina episodes. Antiplatelet agents may also be beneficial but are more commonly used to prevent thrombotic events rather than directly addressing vasospasm.

Overall, avoiding β-blockers in this scenario is critical due to their mechanism of action which can inadvertently lead to more frequent or severe episodes of ischemia in patients with Prinzmetal angina.