ABSTRACT
Stable angina is the clinical manifestation of cardiac ischemia as a result of a mismatch between myocardial oxygen demand and supply. It is highly prevalent in the population, results in decreased quality of life, and has signifi cant implications regarding prognosis of cardiovascular events. Patients with stable angina should be risk stratifi ed to identify the most effective management strategy. Aggressive control of risk factors and optimal medical therapy are the cornerstone of treatment for all patients with stable angina. Persistent symptoms, the magnitude of the ischemic burden, or drug intolerance should drive decision making regarding revascularization. Revascularization is very effective treatment for stable angina when performed on targeted culprit stenoses that are hemodynamically signifi cant or causing ischemia. The method of choice for revascularization depends on the angiographic characteristics of the lesions causing ischemia, left ventricular (LV) dysfunction, and suitability of the patient for surgery in terms of comorbidities, and likelihood of technical success. The ultimate decisions regarding patient care must incorporate evidence based medicine as well as the patient’s preference based upon a balanced discussion of the treatment options and realistic expectations of the quality of life.
