Ischemic Heart Disease.

The goals of treatment of ischemic heart disease are to relieve symptoms, prevent unstable angina or myocardial infarction, and prolong life. Over the past four decades, significant advances in therapy have occurred, initially involving revascularization procedures. Although coronary bypass surgery and percutaneous catheter-based interventions continue to play an important role in therapy, appropriate medical therapy has been shown to have a major impact on the course of the disease and can decrease the need for revascularization. Lifestyle changes (eg, cessation of smoking) and pharmacologic therapy (eg, the use of aspirin, beta-blockers, and lipid-lowering agents) have been shown to decrease the occurrence of acute ischemic events and to prolong life in patients with coronary disease. Although it is likely that new therapies will emerge as our understanding of the basic mechanism of atherosclerosis increases, it is important to be sure that current medical therapy is provided to all appropriate patients.