Revascularization treatment of stable coronary artery disease

Introduction: Coronary artery disease (CAD) is the leading cause of mortality in developed countries. Angina, myocardial infarction, heart failure and other clinical manifestations of coronary atherosclerosis lead to considerable patient morbidity and constitute an increasingly heavy burden on health systems worldwide. Areas covered: This article reviews the recent major developments in the treatment of CAD, which can be achieved using medical therapy either in isolation or in combination with revascularization, performed via coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI). There is no dispute that optimal medical treatment is the cornerstone of CAD management; however, timely revascularization offers superior symptom control in patients with severe symptoms and may also offer a survival advantage in some patients with diffuse disease and diabetes. Importantly, the advances in PCI technology, especially with the introduction of drug-eluting stents has narrowed the gap between CABG and PCI for the treatment of CAD. Expert opinion: The continuous developments in diagnosis and treatment of CAD call for contemporary trials with detailed analysis to provide evidence that will help in the choice of the best and most cost-effective treatment strategy.

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