Treatment

Treatment for coronary artery disease usually involves lifestyle changes and, if necessary, drugs and certain medical procedures.

Lifestyle changes

Making a commitment to the following healthy lifestyle changes can go a long way toward promoting healthier arteries:

• Quit smoking.
• Eat healthy foods.
• Exercise regularly.
• Lose excess weight.
• Reduce stress.

Drugs

Various drugs can be used to treat coronary artery disease, including:

• Cholesterol-modifying medications. These medications reduce (or modify) the primary material that deposits on the coronary arteries. As a result, cholesterol levels — especially low-density lipoprotein (LDL, or the "bad") cholesterol — decrease. Your doctor can choose from a range of medications, including statins, niacin, fibrates and bile acid sequestrants.

• Aspirin. Your doctor may recommend taking a daily aspirin or other blood thinner. This can reduce the tendency of your blood to clot, which may help prevent obstruction of your coronary arteries.

  If you've had a heart attack, aspirin can help prevent future attacks. But aspirin can be dangerous if you have a bleeding disorder or you're already taking another blood thinner, so ask your doctor before taking it.

• Beta blockers. These drugs slow your heart rate and decrease your blood pressure, which decreases your heart's demand for oxygen. If you've had a heart attack, beta blockers reduce the risk of future attacks.
• Calcium channel blockers. These drugs may be used with beta blockers if beta blockers alone aren't effective or instead of beta blockers if you're not able to take them. These drugs can help improve symptoms of chest pain.
• Ranolazine. This medication may help people with chest pain (angina). It may be prescribed with a beta blocker or instead of a beta blocker if you can't take it.
• Nitroglycerin. Nitroglycerin tablets, sprays and patches can control chest pain by temporarily dilating your coronary arteries and reducing your heart's demand for blood.
• Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). These similar drugs decrease blood pressure and may help prevent progression of coronary artery disease.

Procedures to restore and improve blood flow

Sometimes more aggressive treatment is needed. Here are some options:

Angioplasty and stent placement (percutaneous coronary revascularization)

Your doctor inserts a long, thin tube (catheter) into the narrowed part of your artery. A wire with a deflated balloon is passed through the catheter to the narrowed area. The balloon is then inflated, compressing the deposits against your artery walls.

A stent is often left in the artery to help keep the artery open. Most stents slowly release medication to help keep the arteries open.

Coronary artery bypass surgery

A surgeon creates a graft to bypass blocked coronary arteries using a vessel from another part of your body. This allows blood to flow around the blocked or narrowed coronary artery. Because this requires open-heart surgery, it's most often reserved for people who have multiple narrowed coronary arteries.