Treating Coronary Artery Disease
Treatment is based on the patient’s age, overall health and medical history. Also considered are the disease’s extent; patient tolerance for specific medications, procedures or therapies; expectations for the disease’s course or extent; and the patient’s preferences.
Treatment may include:
- Risk Factor Modification – This includes smoking, elevated cholesterol levels, elevated blood glucose levels, lack of exercise, poor dietary habits, being overweight/obese and elevated blood pressure.
- Medications -- These include:
- Antiplatelets - Used to decrease the ability of platelets in the blood to stick together and cause clots. Examples include Aspirin, clopidogrel (Plavix®), ticlopidine (Ticlid®), and dipyridamole (Persantine®).
- Anticoagulants - Also described as "blood thinners," these medications work differently than antiplatelets to decrease the ability of the blood to clot. An example of an anticoagulant is warfarin (Coumadin®).
- Antihyperlipidemics - Used to lower lipids (fats) in the blood, particularly Low Density Lipid (LDL) cholesterol. Statins are a group of antihyperlipidemic medications, and include simvastatin (Zocor®), atorvastatin (Lipitor®) and pravastatin (Pravachol®), among others.
- Bile acid sequestrants - colesevelam, cholestyramine and colestipol - and nicotinic acid (niacin) are two other types of medications that may be used to reduce cholesterol levels.
- Antihypertensives - Used to lower blood pressure. There are several different groups of medications which act in different ways to lower blood pressure.
- Coronary Angioplasty – A balloon is used to create a bigger opening in the vessel to increase blood flow. Although angioplasty is performed in other blood vessels elsewhere in the body, percutaneous coronary intervention (PCI) refers to angioplasty in the coronary arteries to permit more blood flow into the heart. PCI is also called percutaneous transluminal coronary angioplasty (PTCA).
- Coronary Artery Stent - A tiny coil is expanded inside the blocked artery to open the blocked area. The coil is left in place to keep the artery open.
- Atherectomy - the blocked area inside the artery is cut away by a tiny device on the end of a catheter.
- Laser Angioplasty - a laser used to "vaporize" the blockage in the artery.
- Coronary Artery Bypass - Commonly referred to as "bypass surgery," this procedure often is performed in people who have angina (chest pain) and coronary artery disease (where plaque has built up in the arteries). Surgeons create a bypass by grafting a piece of a vein above and below the blocked area of a coronary artery, enabling blood to flow around the obstruction. Veins usually are taken from the leg, but arteries from the chest or arm sometimes may be used to create a bypass graft.
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