Coronary artery disease
By The Treatment Registry editors
Atherosclerotic narrowing of coronary arteries causing ischaemia and angina. Treatment is staged from lifestyle and medical therapy through percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG). The choice between PCI and CABG in multi-vessel disease requires multidisciplinary heart-team assessment per current ACC/AHA guidance.
Treatment ladder
Conservative options are first-line where appropriate; surgical options are typically reserved for cases where lower-tier options are unsuitable or have failed. Decisions are individual and depend on clinical assessment.
Conservative
- Risk-factor modification and medical therapy
Smoking cessation, lipid lowering (statins), blood-pressure control, antiplatelet therapy (aspirin), antianginal medications (beta-blockers, calcium-channel blockers, nitrates). Foundation of all coronary disease management; often sufficient for stable angina without high-risk anatomy.
Procedural
- Percutaneous coronary intervention (PCI)
Catheter-based stent placement, with or without atherectomy. Less invasive than CABG; preferred in single-vessel disease and in many multi-vessel cases without left-main or complex multi-vessel disease.
Surgical
- Coronary artery bypass graft (CABG) · View procedure page
Surgical revascularisation using internal mammary artery and saphenous vein/radial artery grafts. Superior to PCI for left-main disease, complex multi-vessel disease, and diabetic patients with multi-vessel disease per AHA/ACC guidance.