Conclusion
This is a classic story of angina pectoris and chronic stable coronary artery disease. Optimal medical therapy, both pharmaceutic and lifestyle, has been shown in multiple clinical trials to be associated with a good outcome, and has played a significant role in the reduction in cardiovascular disease mortality in recent decades. Except in special groups, revascularization is largely a treatment for angina. Where angina is disabling, revascularization can have a dramatic effect on quality of life. By beginning with optimal medical therapy, clinical trial data have shown that revascularization can be safely deferred in many patients. When angina pectoris does not improve over time in the medically treated patient, then revascularization with PCI or CABG is indicated.25
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