How is coronary artery disease treated?

The treatment of coronary disease is geared toward relief of symptoms of angina and reduction of the risk of future heart attack or death from cardiac cause. Several medications have been shown to reduce mortality from coronary disease. Aspirin, which is a weak blood thinner, reduces the risk of a first heart attack or of a future heart attack in a patient who has already suffered one. Aspirin exerts its protective effect by weakly blocking the action of platelets, the blood cells that bring about clotting.

The classes of blood pressure drugs known as beta blockers and ACE-inhibitors similarly reduce mortality (by a mechanism that is independent of their effects on blood pressure).

The cholesterol-lowering agents known as statin drugs (because they end in a suffix - "statin") also lower the risk of heart attack and mortality. These drugs seem to act by "stabilizing" existing plaques and preventing plaque progression, rather than by "shrinking" plaque.

The class if drugs known as "nitrates," such as nitroglycerine, are very effective in relieving symptoms of chest pain. These drugs do not have any effect on the natural course of the disease atherosclerosis and do not change mortality.

Coronary angioplasty and coronary bypass surgery, described below, are very effective in treating the symptoms of angina. In addition, in cases where the heart muscle is severely weakened by the presence of coronary disease, coronary bypass also prolongs life.