Managing Stable Ischemic Heart Disease

The preferred contemporary approach to the management of stable ischemic heart disease, also referred to as chronic coronary syndrome,(1) is not well defined. Two strategies are commonly used.(2) The conservative strategy uses guideline-based medical therapy, including antianginal drugs as well as disease-modifying agents, such as hypolipidemic, antithrombotic, and renin-angiotensin blocking therapies. The invasive strategy adds coronary angiography, followed by either percutaneous coronary intervention or coronary-artery bypass grafting, to guideline-based medical therapy. Important advances have occurred in both strategies, leading to equipoise as to which approach is preferable for patients with stable ischemic heart disease.(3,4) The International Study of Comparative Health . . .