Medical therapy and lifestyle modifications effectively manage stable coronary heart disease, confining the role of revascularization to patients with unacceptable angina or high-risk anatomy.
Medical therapy and prevention are highly effective for stable coronary heart disease, with revascularization largely reserved for patients with unacceptable angina, severe left ventricular systolic dysfunction, or high-risk coronary anatomy.
Coronary heart disease is a chronic, systemic disease with a wide range of associated symptoms, clinical outcomes, and health care expenditure. Adverse events from coronary heart disease can be mitigated or avoided with lifestyle and risk factor modifications, and medical therapy. These measures are effective in slowing the progression of atherosclerotic disease and in reducing the risk of thrombosis in the setting of plaque disruptions. With increasing effectiveness of prevention and medical therapy, the role of coronary artery revascularization has decreased and is largely confined to subgroups of patients with unacceptable angina, severe left ventricular systolic dysfunction, or high-risk coronary anatomy. There is a compelling need to allocate resources appropriately to improve prevention. Herein, we review the scientific evidence in support of medical therapy and revascularization for the management of patients with stable coronary heart disease and discuss implications for the evaluation of patients with stable angina and public policy.
Ferraro et al. (Sun,) conducted a review in Stable coronary heart disease and stable angina. Medical therapy and revascularization was evaluated. Medical therapy and lifestyle modifications effectively manage stable coronary heart disease, confining the role of revascularization to patients with unacceptable angina or high-risk anatomy.