Drug therapy or coronary angioplasty for the treatment of coronary artery disease: New insights

Background In the last decade percutaneous transluminal coronary angioplast y has become a very popular strategy For the treatment of coronary artery d isease, although its efficacy in reducing ischemic events and the subsequen t need for revascularization has yet to be proved. Methods We reviewed the latest trials that compared percutaneous translumin al coronary angioplasty and medical therapy. Results We discuss the potentially favorable effect of lipid-lowering thera py on coronary atherosclerosis and cardiac events and comment on the result s of the recent Atorvastatin Versus Revascularization Treatments (AVERT) st udy that compared lipid-lowering treatment and percutaneous transluminal co ronary angioplasty in patients with stable coronary artery disease. Conclusions Medical treatment aimed at reversing plaque growth and promotin g plaque stabilization should probably be considered as the initial therape utic option. Statin class drugs, together with aggressive management of kno wn risk Factors, show promise as the first step after appropriate early dia gnosis. Revascularization procedures should subsequently be considered for all patients who do not respond to medical treatment or in whom the disease shows clear signs of progression.