Managing chronic stable angina: A comprehensive review of percutaneous coronary intervention versus coronary artery bypass grafting

p.padamavthi

» doi: https://jcdponline.org/.2011.v02.i02.pp01-06

Abstract

Myocardial ischemia with permanent atherosclerotic coronary stenosis causes adaptation of coronary circulation to become impaired, leading to an elevated oxygen demand, and the clinical manifestation of this is chronic stable angina. We advocate for the use of appropriate pharmacological treatment, which includes ACE inhibitors, beta-blockers, statins, and nitrates, for all patients upon diagnosis of chronic stable angina. Coronary angiography should be considered for individuals whose symptoms persist after the administration of these medications at maximum tolerable doses. It is recommended to administer percutaneous coronary intervention (PCI) to patients who have either singleor double-vessel disease. However, if the coronary angiography reveals left main disease and triple-vessel disease, PCI should be performed and the patient should be evaluated for comorbidities that increase the risk of CABG. Direct surgical revascularization should be pursued by other individua