Materiały źródłowe

• #1 Coronary artery disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/diagnosis-treatment/drc-20350619

  Treatment for coronary artery disease may include: […] Lifestyle changes such as not smoking, eating healthy and exercising more. […] Medicines. […] Heart procedure or heart surgery. […] Many medicines are available to treat coronary artery disease, including: […] Cholesterol medicine. Your healthcare professional might recommend this type of medicine to lower „bad” LDL cholesterol and reduce plaque buildup in the arteries. Such medicines include statins, niacin, fibrates and bile acid sequestrants. […] Aspirin helps thin the blood and prevent blood clots. Daily low-dose aspirin therapy may be recommended for the primary prevention of heart attack or stroke in some people. […] Beta blockers. These medicines slow the heartbeat and lower blood pressure. If you’ve had a heart attack, beta blockers may reduce the risk of future heart attacks.

• #2 Coronary Heart Disease – Treatment | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/coronary-heart-disease/treatment

  Treatment for coronary heart disease depends on how serious your symptoms are and any other health conditions you have. […] If your healthcare provider diagnoses you with coronary heart disease, treatment may include heart-healthy lifestyle changes, medicines, or procedures to prevent a heart attack or other health problems. […] Together, you and your provider can make a treatment plan that is right for you. […] Your provider may also recommend medicines to help manage cholesterol levels in your blood: […] Some medicines can help manage health conditions that are risk factors for coronary heart disease: […] You may need a procedure or heart surgery to treat serious coronary heart disease and lower your risk of complications: […] Percutaneous coronary intervention (PCI), also called coronary angioplasty, opens coronary arteries that are narrowed or blocked by the buildup of plaque.

• #2 Coronary artery disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/diagnosis-treatment/drc-20350619

  Calcium channel blockers. One of these medicines may be suggested if you can’t take beta blockers or beta blockers don’t work for you. Calcium channel blockers can help reduce chest pain. […] Angiotensin-converting enzyme (ACE) inhibitors and angiotensin 2 receptor blockers (ARBs). These medicines lower blood pressure. They may help keep coronary artery disease from getting worse. […] Nitroglycerin. This medicine widens the heart arteries. It can help control or reduce chest pain. Nitroglycerin is available as a pill, spray or patch. […] Ranolazine. This medicine may help people with long-term chest pain. It may be prescribed with or instead of a beta blocker. […] Surgery may be done to fix a blocked artery and improve blood flow. Surgeries or procedures for coronary artery disease may include:

• #2 Coronary Heart Disease – Treatment | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/coronary-heart-disease/treatment

  Coronary artery bypass grafting (CABG) improves blood flow to the heart by using healthy arteries from the chest wall and veins from the legs to bypass the blocked arteries. […] Bariatric (weight loss) surgery can help lower the risk of coronary heart disease and other problems that affect the blood vessels of people with obesity, especially for people who also have diabetes.

• #3 Coronary Artery Disease (CAD): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease

  Coronary artery disease treatment often includes lifestyle changes, risk factor management and medications. Some people may also need a procedure or surgery. […] Your healthcare provider will talk with you about the best treatment plan for you. Its important to follow your treatment plan so you can lower your risk of serious complications from CAD. […] Lifestyle changes play a big role in treating coronary artery disease. Such changes include: […] Managing your risk factors for CAD can help slow down the progression of your disease. Work with your provider to manage the following conditions: […] Medications can help you manage your risk factors and treat symptoms of coronary artery disease. Your provider may prescribe one or more medications that: […] Some people need a procedure or surgery to manage coronary artery disease, including:

• #3 Coronary artery disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/diagnosis-treatment/drc-20350619

  Coronary angioplasty and stent placement. This treatment opens clogged blood vessels in the heart. A tiny balloon on a thin tube, called a catheter, is used to widen a clogged artery and improve blood flow. A small wire mesh tube called a stent may be placed to keep the artery open. […] Coronary artery bypass graft (CABG) surgery. This is a type of open-heart surgery. During CABG, a surgeon takes a vein or artery from somewhere else in the body. The surgeon uses the blood vessel to create a new path for blood to go around a blocked or narrowed heart artery. The surgery increases blood flow to the heart. […] If you’ve had coronary artery bypass surgery, your healthcare professional may suggest cardiac rehabilitation. This is a program of education, counseling and exercise training that’s designed to help improve your health after heart surgery.

• #4 Coronary artery disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613

  Treatment for coronary artery disease may include medicines and surgery. […] Treating coronary artery disease usually means making changes to your lifestyle. This might be eating healthier foods, exercising regularly, losing excess weight, reducing stress or quitting smoking. The good news is these changes can do a lot to improve your outlook. Living a healthier life translates to having healthier arteries. When necessary, treatment could involve drugs like aspirin, cholesterol-modifying medications, beta-blockers, or certain medical procedures like angioplasty or coronary artery bypass surgery.

• #5 Coronary artery disease | Heart and Stroke Foundation

  https://www.heartandstroke.ca/heart-disease/conditions/coronary-artery-disease

  There is no cure for CAD, but there are many treatments, including medications, surgery and lifestyle changes, that can slow down its progress. […] Medications used to treat coronary artery disease include: anti-platelets, ACE inhibitors, beta-blockers, calcium channel blockers, nitrates (Nitroglycerin). […] Your doctor may also suggest these procedures: percutaneous coronary intervention (PCI or angioplasty with stent), coronary artery bypass surgery. […] You can lower your risk of other heart diseases and stroke by knowing and controlling your blood pressure, diabetes and blood cholesterol. It is also important to lead a healthy lifestyle: Be smoke-free, Be more active, Eat a healthy balanced diet there are some specific diets you can follow that have been proven to reduce the risk of heart disease, Aim for a healthy weight, Drink less alcohol, Manage stress.

• #6 Medical Management of Stable Coronary Artery Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p819.html

  All patients with stable coronary artery disease require medical therapy to prevent disease progression and recurrent cardiovascular events. Three classes of medication are essential to therapy: lipid-lowering, antihypertensive, and antiplatelet agents. […] Lipid-lowering therapy is necessary to decrease low-density lipoprotein cholesterol to a target level of less than 100 mg per dL, and physicians should consider a goal of less than 70 mg per dL for very high-risk patients. […] Blood pressure therapy for patients with coronary artery disease should start with beta blockers and angiotensin-converting enzyme inhibitors. […] Aspirin is the first-line antiplatelet agent except in patients who have recently had a myocardial infarction or undergone stent placement, in which case clopidogrel is recommended.

• #7 Medical Management of Stable Coronary Artery Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p819.html

  Antiplatelet therapy is an important component of CAD management because platelet aggregation at atherothrombotic plaque sites can produce clinically significant thrombosis and resultant MI. […] The benefit of aspirin in the secondary prevention of CAD is well defined by numerous studies and is reflected in international guidelines. […] Clopidogrel is approved by the U.S. Food and Drug Administration for the treatment of acute coronary syndrome, recent MI, stroke, and peripheral arterial disease.

• #7 Medical Management of Stable Coronary Artery Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0401/p819.html

  Familiarity with these medications and with the evidence supporting their use is essential to reducing morbidity and mortality in patients with coronary artery disease. […] All patients with stable CAD require medical therapy to alleviate symptoms, prevent cardiovascular events, and reduce mortality. […] Statins limit the synthesis of cholesterol and increase the catabolism of low-density lipoprotein (LDL) cholesterol. […] The National Cholesterol Education Program’s Adult Treatment Panel III recommends using statins to achieve LDL levels of less than 100 mg per dL (2.59 mmol per L) in patients with CAD. […] Beta blockers are first-line antihypertensive agents for patients with CAD; if tolerated, beta blockers are also indicated for patients who do not have hypertension. […] Angiotensin-converting enzyme (ACE) inhibitors should be used in patients with CAD following MI, those who have diabetes, or those with left ventricular dysfunction.

• #8 Heart Attack Treatment | American Heart Association

  https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack

  Heart attack treatment involves a variety of medications. […] Some people are treated with two types of antiplatelet agents at the same time to prevent blood clotting. This is called dual antiplatelet therapy (DAPT). […] One antiplatelet agent is aspirin. Many people with coronary artery disease are treated with aspirin for the rest of their lives. A second antiplatelet agent, called a P2Y12 inhibitor, is prescribed for months or years in addition to aspirin therapy. […] If you had a heart attack and a coronary artery stent placed, or you are being treated with medical therapy (no stent or surgery), in addition to aspirin, your health care team may prescribe a P2Y12 inhibitor for 6-12 months. In some cases, it may be advisable to be on DAPT longer.

• #9 Coronary Artery Atherosclerosis Treatment & Management: Approach Considerations, Preventive Strategies, Treatment of Low HDL levels and High Triglyceride levels in Patients With Diabetes

  https://emedicine.medscape.com/article/153647-treatment

  The goals of therapy should include arresting atherosclerosis or even reversing its progression. […] Substantial evidence supports the use of statins in the secondary prevention of CAD, and the efficacy of statins has recently been extended to include primary prevention of CAD in patients with average cholesterol levels. […] Current guidelines recommend using statin therapy after CABG to keep LDL levels below 100 mg/dL. […] Statin therapy is also safe and can improve liver tests while reducing cardiovascular morbidity in patients with mild- to moderately-abnormal liver test results that may be attributable to nonalcoholic fatty liver disease. […] The 2013 AHA/ACC guidelines also recommend use of a revised calculator to estimate the risk of developing a first atherosclerotic cardiovascular disease (ASCVD) event.

• #9 Coronary Artery Atherosclerosis Treatment & Management: Approach Considerations, Preventive Strategies, Treatment of Low HDL levels and High Triglyceride levels in Patients With Diabetes

  https://emedicine.medscape.com/article/153647-treatment

  The treatment goals for patients with coronary artery atherosclerosis are to relieve symptoms of coronary artery disease (CAD) and to prevent future cardiac events, such as unstable angina, AMI, and death. […] The mainstays of pharmacologic therapy of angina include nitrates, beta-blockers, statins, PCSK-9 inhibitors, Ezetimibe, calcium-channel blockers, and ranolazine. […] The prevention and treatment of atherosclerosis requires control of the known modifiable risk factors for this disease. This includes therapeutic lifestyle changes and the medical treatment of hypertension, hyperlipidemia, and diabetes mellitus. […] High-risk subgroups, in particular, can be targeted for early intervention. […] Pharmacotherapeutic strategies that affect the risk factor profile, such as the administration of statins for low-density lipoprotein (LDL) reduction or the administration of agents that alter atherosclerotic plaque, are of paramount importance.

• #9 Coronary Artery Atherosclerosis Treatment & Management: Approach Considerations, Preventive Strategies, Treatment of Low HDL levels and High Triglyceride levels in Patients With Diabetes

  https://emedicine.medscape.com/article/153647-treatment

  In patients with atherosclerotic cardiovascular disease, or those with LDL cholesterol levels 190 mg/dL or higher, and no contraindications, high-intensity statin therapy should be prescribed to achieve at least a 50% reduction in LDL cholesterol. […] In patients aged 40 to 75 years of age with diabetes, a moderate-intensity statin that lowers LDL cholesterol by 30% to 49% should be used; in those patients who also have a 10-year risk of atherosclerotic cardiovascular disease exceeding 7.5%, a high-intensity statin is a reasonable choice. […] A combination of low HDL levels and high triglyceride levels is frequently encountered in patients with diabetes and is often referred to as atherogenic dyslipidemia. […] ACE inhibitors are effective blood pressure-reducing agents and affect the heart and vasculature through direct and other mechanisms.

• #9 Coronary Artery Atherosclerosis Treatment & Management: Approach Considerations, Preventive Strategies, Treatment of Low HDL levels and High Triglyceride levels in Patients With Diabetes

  https://emedicine.medscape.com/article/153647-treatment

  The 2007 ACC/AHA guidelines recommend that after an ACS, all patients should receive dual antiplatelet therapy, ideally for 12 months, followed by lifelong aspirin therapy. […] The latest advice in this controversial area advocates a personalized-medicine approach based on ischemic versus bleeding risks, where each treatment and its duration is individualized as much as possible. […] A number of agents have proven helpful for the treatment of angina. These include beta-blockers, calcium channel blockers, nitrates, and ranolazine. […] Hormone therapy has been found to be more risky than beneficial as a means of protecting postmenopausal women against CAD. […] Although inflammation is considered to be a risk factor for the development of atherosclerosis, antibiotic therapy does not appear to have a significant role in secondary prevention of this disorder.

• #9 Coronary Artery Atherosclerosis Treatment & Management: Approach Considerations, Preventive Strategies, Treatment of Low HDL levels and High Triglyceride levels in Patients With Diabetes

  https://emedicine.medscape.com/article/153647-treatment

  Revascularization therapies for symptomatic or ischemia-producing atherosclerotic lesions include percutaneous approaches and open heart surgery. […] Patients presenting with stable angina or ischemia after physiologic testing and who have undergone revascularization therapy, either in the form of PCI or CABG, benefit from adjuvant pharmacologic therapy and aggressive risk reduction.

• #10 Medications for Treatment of Coronary Artery Disease – Heart and Blood Vessel Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/coronary-artery-disease/medications-for-treatment-of-coronary-artery-disease

  Ranolazine and ivabradine are alternative therapies for people with angina that does not respond to the usual therapies (for example, nitrates or morphine). […] This class of medication is used for people whose levels of low-density lipoprotein cholesterol (LDL-C), which is the „bad” cholesterol, is not at the target level. PCSK-9 inhibitors, such as alirocumab or evolocumab, are used alone or in combination with other lipid-lowering medications (for example, statins or ezetimibe) for the treatment of adults with primary hyperlipidemia, including familial hypercholesterolemia. They can be particularly useful for people who have difficulty tolerating the side effects of other medications that lower cholesterol levels.

• #11 Management of Coronary Artery Disease and Chronic Stable Angina

  https://www.uspharmacist.com/article/management-of-coronary-artery-disease-and-chronic-stable-angina

  Beta-blockers reduce myocardial oxygen consumption through a decrease in heart rate and myocardial contractility. This medication class is recommended to be initiated and continued for 3 years in patients with normal left ventricular function after an MI. For patients with left ventricular dysfunction, beta-blocker therapy should be continued indefinitely. […] A body of evidence suggests that ACE inhibitors, in addition to their established efficacy in the management of hypertension, have benefits extending beyond their BP-lowering effects. Clinical trials have consistently shown that ACE inhibitors reduce the risk of morbidity and mortality from HF, stroke, MI, diabetes, and renal impairment. ACE inhibitors may also offer a protective effect for patients with SIHD. […] Nitrates, which are effective at managing all forms of angina, are first-line therapy for the management of acute anginal symptoms. Long-acting nitrates, such as isosorbide dinitrate, isosorbide mononitrate, and nitroglycerin, are recommended when beta-blockers or calcium channel blockers are not tolerated or are contraindicated, or when additional therapy is needed to achieve symptom control.

• #11 Management of Coronary Artery Disease and Chronic Stable Angina

  https://www.uspharmacist.com/article/management-of-coronary-artery-disease-and-chronic-stable-angina

  Ranolazine (Ranexa) is another therapy for chronic angina. It works by inhibiting the late inward sodium current in heart muscle and reducing sodium-dependent calcium levels, leading to a reduction in heart-wall tension and a decrease in oxygen consumption. […] Revascularization refers to procedures that are performed to restore blood flow to the tissues. Coronary artery bypass graft (CABG) and PCI are revascularization procedures performed in patients to address SIHD. These procedures may be performed either for symptomatic relief or to improve survival. The Heart Team approach (i.e., multidisciplinary care) is recommended in patients with diabetes mellitus and complex multivessel disease. In this subset of patients, CABG is preferred to PCI to improve survival. […] The primary goals of treatment for patients with SIHD are to maximize quality of life and minimize the risk of death. Risk-factor reduction can be achieved through the optimal management of diabetes, hypertension, and hyperlipidemia. Additional therapies known to reduce the incidence of cardiac events, such as aspirin, weight loss, smoking cessation, and exercise, should be implemented to manage symptoms. Beta-blockers are the preferred initial agents; however, calcium channel blockers, ranolazine, and nitrates may be used to relieve symptoms when initial beta-blocker treatment is unsuccessful or if beta-blockers are contraindicated or cause intolerable adverse effects.

• #12

  https://www2.hse.ie/conditions/coronary-heart-disease-chd/treatment/

  Calcium channel blockers work to lower blood pressure. […] Diuretics work by flushing excess water and salt from the body through urine. […] A procedure may be needed to open up or bypass narrow heart arteries if your blood vessels are narrow as the result of a build-up of atheroma (fatty deposits) or symptoms cannot be controlled using medicines. […] Procedures to treat blocked arteries include coronary angioplasty, coronary artery bypass graft and heart transplant. […] Coronary angioplasty is also known as: percutaneous coronary intervention (PCI), percutaneous transluminal coronary angioplasty (PTCA), balloon angioplasty. […] Coronary artery bypass grafting is also known as: bypass surgery, a heart bypass, coronary artery bypass surgery. […] A heart transplant replaces a damaged heart with a healthy donor heart.

• #13 Ischemic heart disease treatments | PortalCLÍNIC

  https://www.clinicbarcelona.org/en/assistance/diseases/ischemic-heart-disease/treatment

  Coronary revascularisation or heart bypass surgery. Sometimes more than one coronary artery is blocked or there are multiple lesions which are difficult to treat with an angioplasty. An alternative solution for such cases is to perform heart bypass surgery. […] The essential objective of long-term treatment is secondary prevention, i.e., to ensure there is no recurrence of the angina or infarction (heart attack). This requires a combination of lifestyle changes and drug therapy. […] Patients with Ischaemic Heart Disease must take a combination of drugs to reduce the hearts oxygen consumption, dilate the coronary arteries and prevent the formation of a new blockage. […] Nitroglycerine and its derivatives (nitrates, either as tablets or transdermal patches): these drugs are known as vasodilators. They relax the arteries and veins, including the coronary vessels, thereby increasing blood flow in the affected area and eliminating chest pain from angina.

• #14 Ischemic heart disease treatments | PortalCLÍNIC

  https://www.clinicbarcelona.org/en/assistance/diseases/ischemic-heart-disease/treatment

  Beta-blockers (bisoprolol, carvedilol, nebivolol, metoprolol, atenolol, etc.): decrease blood pressure and heart rate, hence the heart requires less oxygen to function correctly. […] Platelet aggregation inhibitors. Patients who have suffered any event brought on by atherosclerosis must take platelet aggregation inhibitors permanently, unless they are contraindicated. […] Statins. These drugs reduce blood cholesterol levels. They also help stabilise and prevent the rupture of atheromatous plaques, reduce blood vessel inflammation and decrease the likelihood of an infarction. […] Other anti-anginal agents are calcium channel blockers, relax the muscles of the coronary arteries and mitigate the effects of obstructions and spasms; ivabradine reduces heart rate and so the heart requires less oxygen and ranolazine acts on the primary and secondary blood vessels and decreases the risk of angina.

• #15

  https://www.nhs.uk/conditions/coronary-heart-disease/treatment/

  Treatment for coronary heart disease (CHD) can help manage the symptoms and reduce the risk of further problems. […] CHD can be managed effectively with a combination of lifestyle changes, medicine and, in some cases, surgery. […] With the right treatment, the symptoms of CHD can be reduced and the functioning of the heart improved. […] Many different medicines are used to treat CHD. Usually they either aim to reduce blood pressure, widen your arteries or prevent blood clots. […] Some heart medicines have side effects, so it may take a while to find one that works for you. A GP or specialist will discuss the various options with you. […] Heart medicines should not be stopped suddenly without the advice of a doctor as there’s a risk this may make your symptoms worse. […] If your blood vessels are narrow as the result of a build-up of atheroma (fatty deposits) or if your symptoms cannot be controlled using medicines, interventional procedures or surgery may be needed to open up or bypass blocked arteries.

• #16

  https://www.nhs.uk/conditions/coronary-heart-disease/treatment/

  Coronary angioplasty is also known as percutaneous coronary intervention (PCI), percutaneous transluminal coronary angioplasty (PTCA) or balloon angioplasty. […] Coronary artery bypass grafting (CABG) is also known as bypass surgery, a heart bypass, or coronary artery bypass surgery. […] Occasionally, when the heart is severely damaged and medicine is not effective, or when the heart becomes unable to adequately pump blood around the body (heart failure), a heart transplant may be needed.

• #17

  https://www.bostonscientific.com/en-US/patients-caregivers/treatments-conditions/coronary-stents.html

  Bare-metal stents are tiny wire mesh tubes that help widen a clogged artery but are not coated with a polymer or drugs to help prevent re-blockage of the artery. This type of stent may be used in patients who are allergic to either polymer or drugs used in drug-eluting stents. […] A drug-eluting stent is a bare-metal stent that has been coated with a polymer that gradually releases a drug over the time when re-blockage is most likely to happen. This helps reduce the chance of the artery becoming blocked again.

• #18 The Treatment of Coronary Artery Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9835700/

  The use of CABG and PCI can also contribute towards symptom relief and, potentially, to an improvement in prognosis in patients with clinically relevant CAD. However, given their potential for harm, some evidence of benefit should first be demonstrated. […] The guidelines recommend that PCI be individualized for patients with chronic CAD to take into account clinical condition, stenosis severities, and the various methods used to confirm ischemia. […] The primary aim of a PCI is therefore to eliminate clinically relevant mechanical restrictions to flow. […] The guidelines recommend the use of CABG as primary therapy of anatomically complex CAD; it is considered virtually equivalent to PCI in patients with less anatomical complexity. […] A more recent study showed a survival benefit for CABG over guideline-directed medical therapy in patients with ventricular dysfunction. Overall, patients lived on average 1.5 years longer over ten years after CABG than with medication alone.

• #19 Stable Coronary Artery Disease: Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0315/p376.html

  Treatment of stable CAD involves lifestyle changes, risk factor modification, and antiplatelet and antianginal therapy. […] High-intensity statin therapy is recommended for all patients younger than 75 years with stable CAD, unless contraindicated. Daily low-dose aspirin is recommended for all patients with stable CAD, unless contraindicated. Beta blockers should be continued for up to three years after myocardial infarction in patients with abnormal left ventricular function. Select patients with uncontrolled symptoms of stable CAD despite optimal medical management may benefit from coronary revascularization with percutaneous coronary intervention or coronary artery bypass grafting. […] Select patients with stable CAD may benefit from coronary revascularization with PCI or coronary artery bypass grafting (CABG). These procedures may be considered if an adequate trial of medical therapy fails to manage anginal symptoms. Shared decision making between the patient and physician should take into account the symptom burden, lifestyle limitations, and personal preferences, as well as risks and benefits. It is important to note that PCI does not improve mortality in patients with stable CAD, but it may improve symptoms. A 2007 RCT analyzed optimal medical therapy vs. PCI and found no difference in all-cause mortality and nonfatal MI. The AHA recommends revascularization (preferably CABG) to prevent MI and death in patients with 50% stenosis or greater of the left main coronary artery. CABG is also the preferred treatment for patients with complex multivessel disease and diabetes; a meta-analysis of six RCTs comparing CABG with PCI in patients with multivessel disease found significant reductions in all-cause mortality (NNT = 37 over four years) and MI (NNT = 26 over four years) for those in the CABG group.

• #20 The Treatment of Coronary Artery Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9835700/

  CABG therefore appears particularly beneficial when the anatomic complexity of CAD and/or patient comorbidities are high. […] The extent to which bypass surgery can be safely planned and performed using non-invasive imaging such as coronary computed tomography is currently under investigation. […] Treatment of CAD is always based on medication, which may also be supplemented by invasive procedures. The effect of PCI and bypass surgery basically comprises three components which are utilized to different degrees by the two procedures: improvement of coronary flow capacity in exercise-induced ischemia, reperfusion in acute ischemia, and prevention of myocardial infarction by surgical collateralization or PCI of lesions that cause infarction. […] In the presence of chronic CAD, invasive procedures can supplement optimal conservative therapy: When symptoms are persistent or pronounced, improving coronary flow capacity can help alleviate symptoms and increase quality of life. With anatomically complex CAD, especially in the presence of diabetes mellitus and/or heart failure, bypass surgery provides additional prognostic benefit, presumably by means of infarction prevention through surgical collateralization.

• #21 What Is Coronary Artery Disease? Causes, Symptoms, Treatment, Prevention

  https://www.webmd.com/heart-disease/coronary-artery-disease

  Depending on your case, your treatment plan may include one or a combination of the following treatments: […] You may need to take medicines to help your heart be healthier. They can include blood thinners (anticoagulants), aspirin and other anti-clotting medicines, ACE inhibitors, beta-blockers, nitroglycerin, calcium channel blockers, certain immunosuppressants, statins, or PCSK9s. […] Part of your treatment plan may involve surgery. Some of the most commonly performed procedures for coronary artery disease include: […] This procedure can open blocked or narrowed arteries without opening up your chest. In angioplasty, a doctor threads a thin, flexible tube with a balloon through your blood vessels until it reaches the blocked artery. The doctor then inflates the balloon, which stretches the artery open so more blood can flow. In many cases, a tiny tube called a stent is also inserted to keep the blood vessel open. You’ll typically be in and out of the hospital in a day.

• #21 What Is Coronary Artery Disease? Causes, Symptoms, Treatment, Prevention

  https://www.webmd.com/heart-disease/coronary-artery-disease

  During this surgery, doctors use blood vessels from other parts of your body to make a detour around blockages in your coronary arteries. It’s a major operation, and you’ll probably need to be in the hospital for at least 5 days. […] If you’ve had a heart attack or cardiac surgery, your doctor will likely recommend that you complete a cardiac rehab program to help you recover. Cardiac rehab will start while you’re in the hospital, then you can attend outpatient appointments once you go home. Most insurance companies will cover 12 weeks of cardiac rehab. Typically, these programs include the following: […] Studies have shown that cardiac rehab can help lower your future risk of stroke, heart attack, depression, and cardiac-related death. […] These time-tested methods sound familiar for a reason — they work!

• #22 Diagnosed With Coronary Artery Disease? Here’s What You Need To Know | Henry Ford Health – Detroit, MI

  https://www.henryford.com/blog/2022/02/diagnosed-with-coronary-artery-disease

  If you have a higher number of blockages that are difficult to access through angioplasty, your doctor may recommend coronary artery bypass surgery. […] After treatment, you’ll see a significant improvement in coronary artery disease symptoms. […] Take all prescribed medications: Continue taking statins or other medications to reduce the risk for future blockages. […] Complete cardiac rehabilitation: If you have an angioplasty or bypass surgery, your cardiac rehabilitation will begin in the hospital. […] Schedule regular doctor visits: You should have ongoing care from a primary care physician and cardiologist. […] Adopt a healthy lifestyle: Make changes in your lifestyle to improve your heart health.

• #23 New Treatment Approach for Advanced Coronary Artery Disease Leads to Improved Outcomes | Mount Sinai – New York

  https://www.mountsinai.org/about/newsroom/2021/new-treatment-approach-for-advanced-coronary-artery-disease-leads-to-improved-outcomes

  Use of a novel technique called the quantitative flow ratio (QFR) to precisely identify and measure the severity of artery blockages can lead to significantly improved outcomes after percutaneous coronary intervention (PCI), according to a new study done in collaboration with Mount Sinai faculty. […] This research, which is the first to analyze QFR and its associated clinical outcomes, may lead to widespread adoption of QFR as an alternative to angiography or pressure wires to measure the severity of blockages, or lesions, in patients with coronary artery disease. […] “For the first time we have clinical validation that lesion selection with this method improves outcomes for patients with coronary artery disease undergoing stent treatment,” says senior author Gregg W. Stone, MD, Director of Academic Affairs for Mount Sinai Health System and Professor of Medicine (Cardiology), and Population Health and Policy, at the Icahn School of Medicine at Mount Sinai.

• #24 New Treatment Approach for Advanced Coronary Artery Disease Leads to Improved Outcomes | Mount Sinai – New York

  https://www.mountsinai.org/about/newsroom/2021/new-treatment-approach-for-advanced-coronary-artery-disease-leads-to-improved-outcomes

  QFR technology uses 3D artery reconstruction and measurement of blood flow velocity that gives precise measurements of the pressure drop across a blockage, allowing doctors to make better decisions as to what arteries to stent during PCI. […] As a result, patients in the QFR group had lower one-year rates of heart attack compared to the angiography-only group (65 patients vs. 109 patients) and a lesser chance of needing additional PCI (38 patients vs. 59 patients) with similar survival. […] The researchers attributed these significant improvements in outcomes to QFR allowing doctors to choose the correct vessels for PCI and also avoid unnecessary procedures. […] “The results from this large-scale blinded randomized trial are clinically meaningful, and similar to what would have been expected with pressure wire-based PCI guidance. Based on these findings, following regulatory approval I would anticipate QFR to be widely adopted by interventional cardiologists to improve outcomes for their patients.”

• #25 Coronary Artery Disease (CAD) | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/coronary-artery-disease-cad

  Treatments for coronary artery disease may comprise of a number of options, including lifestyle changes, medicines, medical procedures and cardiac rehabilitation. […] Coronary artery disease can often be prevented, or effectively treated, with lifestyle improvements and medications. Healthy diet, increased physical activity, weight loss, smoking cessation and reduced stress can lead to impressive results. Medicines used to treat CAD include anticoagulants, aspirins, ACE inhibitors, beta blockers, calcium channel blockers, nitroglycerin and more. […] If you need a medical procedure to treat CAD, you and your doctor can discuss which of these two treatments is right for you: Angioplasty and Stenting, Coronary Artery Bypass Graft (CABG). […] Almost all CAD patients can benefit from cardiac rehabilitation. Physical training encourages safe exercise practices, strengthens your muscles and improves your stamina. Education and counseling help you understand your heart condition and find ways to reduce the risk of future heart problems. When combined with medicine and surgical treatments, cardiac rehabilitation can help you recover faster, feel better, and establish a healthier lifestyle.

• #26 Coronary Artery Disease | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/coronary-artery-disease.html

  We are one of the few centers in the United States specializing in the diagnosis and treatment of non-obstructive coronary artery disease. […] We bring a personalized approach to the management of SCAD and have ongoing research to better understand this disease. […] Our specialists at the Womens Heart Health Clinic have advanced training in understanding the different ways CAD affects women. […] We also have specialized expertise in diagnosing and treating spontaneous coronary artery dissection (SCAD), which affects many more women than men. […] If you are on any medications for CAD and are pregnant, are planning to become pregnant, or are breastfeeding, our cardiologists work with the doctors at Stanfords Gynecology Clinic to ensure that the drugs you are using are safe for you and your baby. […] We recognize that women with CAD have different concerns, including emotional distress. […] At Stanford, we have the tools, technology, and knowledge to find these conditions and provide women with an accurate diagnosis so you can start getting the proper treatment right away.

• #27 The Treatment of Coronary Artery Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9835700/

  Conservative treatment is always the baseline treatment and has undergone major advances in the last few decades. Moreover, non-invasive coronary evaluation with computed tomography, as well as non-invasive cardiac stress imaging studies, are increasingly replacing primary invasive coronary evaluations. In this review, we illustrate a mechanistic concept of the appropriate use of CABG and PCI that can improve patient care, while underscoring the importance of interdisciplinary and intersectoral collaboration. […] There are basically three therapeutic principles for treating coronary artery disease (CAD). Conservative therapy is aimed at treating symptoms, preventing disease progression, and preventing adverse events, especially myocardial infarction. The conservative approach can be complemented by invasive therapy using either percutaneous coronary intervention (PCI) or heart bypass surgery, also known as coronary artery bypass grafting (CABG).

• #28 Complex Coronary Disease

  https://www.umcvc.org/conditions-treatments/comprehensive-complex-coronary-disease

  For many patients with significant coronary artery disease, treatment involves medications along with options to improve blood flow to the heart muscle. These options typically include a procedure where a stent is placed, thus clearing the blockage; or a surgery in which blood is rerouted around the blockage(s). […] Our comprehensive team approach is unique. We review all relevant data including surgical risk and coronary complexity as a team, and factor in other metrics to help determine the best approach for each individual patient. […] Our team of interventional cardiologists has expertise in the diagnosis and treatment of patients with severe coronary artery disease, with specialized training in advanced percutaneous coronary intervention (PCI) procedures. PCI is a non-surgical procedure used to treat narrowing of the hearts coronary arteries.

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