Lifestyle changes (such as dieting, exercising, and quitting smoking) are the first approach for all degrees of coronary artery disease. Depending on severity and individual conditions, patients may also need one or more medications, surgery, or both.
Medications. Many types of medications are used to treat angina and CAD. They include:
- Anti-platelet and anticoagulant drugs (used for preventing heart disease and preventing blood clots prior to surgery or after stent insertion)
- Beta blockers
- ACE inhibitors
- Calcium channel blockers
Interventional Procedures and Surgery. Intervention is usually recommended for people who have:
- Unstable angina that does not respond promptly to medical treatment
- Severe recurrent episodes of angina that last more than 20 minutes
- Acute coronary syndrome
- Severe coronary artery disease (severe angina, multi-artery involvement, evidence of ischemia, or significant narrowing of left main coronary artery), particularly if abnormalities are evident in the left ventricle of the heart, the main pumping chamber
The two main surgical procedures for patients with coronary artery disease are:
- Coronary artery bypass grafting (commonly called bypass or CABG), which is usually reserved for patients with severe coronary artery disease.
- Percutaneous coronary intervention (commonly called angioplasty or PCI), usually with coronary artery stent placement. PCI is less invasive than CABG, but blood vessels can close up again (restenosis) so that patients require additional procedures.
The decision to choose angioplasty or coronary artery bypass depends on a patient’s individual profile, including the number and types of coronary arteries involved, the health stability, previous procedures, patient preference, and more.
Patients considering surgery should discuss all options and risks with their doctors. No surgical procedure cures coronary artery disease, and patients must continue to rigorously maintain a healthy lifestyle and any necessary medications. For some patients, lifestyle changes and medications may be able to control the disease without surgery or angioplasty.
Review Date: 05/05/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.