Can We Predict Future Acute Coronary Events in Patients With Stable Coronary Artery Disease?

Many therapeutic measures have been developed to effectively treat patients with coronary disease. While secondary prevention has become a vital component in maximizing reductions in coronary disease mortality, subsequent acute coronary events still occur and are often unexpected and unpredictable. See also P 325. We now recognize several standard risk factors for the development of coronary disease and a modulation of some of these risk factors has been shown to decrease the incidence and recurrence of coronary events.1-3With the help of noninvasive and invasive cardiologic technology, we may also stratify coronary patients into low- and high-risk subgroups.4Mortality in coronary disease is directly related to the number of diseased vessels, the presence of left ventricular dysfunction, and an ischemic response on treadmill exercise testing, particularly when it occurs during the early stages of exercise. However, as stratification in prognosis is not all or none (ie, only some