Coronary artery disease (CAD) and acute coronary syndrome (ACS) share a pathophysiological basis of myocardial ischemia, primarily driven by atherosclerosis, plaque rupture, and thrombogenesis. Despite advancements in diagnosis and treatment, CAD and ACS continue to pose significant clinical challenges due to variable patient responses, limitations in pharmacological and interventional therapies, and gaps in long-term safety data. Current pharmacologic management integrates conventional agents such as aspirin, clopidogrel, anticoagulants, beta-blockers, and angiotensin-converting enzyme inhibitors. Furthermore, emerging therapies, such as proprotein convertase subtilisin kexin type 9 inhibitors, sodium-glucose co-transporter two inhibitors, RNA-based therapies, and anti-inflammatory agents such as canakinumab, offer innovative approaches to improving patient outcomes and addressing the limitations of traditional therapies. However, adherence remains a challenge, particularly in high-risk patients. Lifestyle modifications and interventional strategies, including percutaneous coronary intervention, coronary artery bypass grafting, transcatheter aortic valve replacement, and hybrid revascularization, provide tailored approaches based on disease severity. Mechanical circulatory support devices, such as Impella pumps, are also critical in managing cardiogenic shock. To optimize CAD and ACS management, a multidisciplinary approach that integrates pharmacological innovations, surgical expertise, algorithm-based interventions, and precision medicine is essential. Improving adherence strategies and refining individualized treatment regimens will be key to advancing cardiovascular care globally.
Sanyaolu et al. (Sat,) studied this question.
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