Stable ischemic heart disease (SIHD) affects approximately 10 million Americans with 500,000 new cases diagnosed each year. Patients with SIHD are primarily managed in the outpatient setting with aggressive cardiovascular risk factor modification via medical therapy and lifestyle changes. Currently, this approach is considered as the mainstay of treatment. The recently published ISCHEMIA trial has established the noninferiority of medical therapy in comparison to coronary revascularization in patients with moderate to severe ischemia. Percutaneous coronary intervention is currently recommended for patients with significant left main disease, large ischemic myocardial burden, and patients with severe refractory angina despite maximal medical therapy.
Competing Interests: Conflict of Interest N.W.S. reports receives educational and research grants from Bard (BD), Intact Vascular, Phillips, Boston Scientific, and Angiodynamics. N.W.S. is on the speaker Bureau of Jansen, Boehringer, Lilly, and Esperion. None of the other authors have any conflict of interest.
(International College of Angiology. This article is published by Thieme.)