The role of optimal medical therapy in patients with stable coronary artery disease

Coronary artery disease (CAD) is a leading cause of mortality and morbidity around the globe. The fact that prevalence and mortality due to CAD are declining in developed countries cannot be held true in developing countries. Almost fourfold increase in CAD prevalence has been reported in India in the past 40 years. This incidence is likely to increase further in the coming years. The heterogeneity of the disease presentation is an important challenge in the management of these patients, and the current therapies are not universally effective in controlling these symptoms. Even with the advancements in medical therapies over the last two decades, it is unclear whether percutaneous coronary intervention (PCI) provides a prognostic advantage over optimal medical therapy (OMT) in the management of stable angina patients. The current review primarily focuses on the use of OMT for stable CAD patients and also discusses the role of coronary revascularization, especially PCI, in the management of these patients. This is based on evidence-based recommendations and guidelines.