Summary

The diagnostic and treatment options for CAD are changing rapidly.

• New pharmaceuticals are being developed and introduced into the treatment armamentarium, particularly novel anti-platelet agents.
• Biologic markers are now used to track coronary artery disease activity at the vascular level, guiding medication selection and dose titration.
• Procedures are less invasive and offer percutaneous treatment options, such as drug-eluting stents, that were previously unavailable.
• Despite these advances, CAD and its deleterious manifestations represent the primary cause of mortality in the U.S. This is largely caused by poor dietary choices; sedentary lifestyles; suboptimal control of serum triglyceride, cholesterol, and glucose levels; inadequate prescription medication administration and delayed dose titration; and ongoing tobacco use.
• Efforts at primary and secondary prevention of obstructive CAD among the general public are still lacking.
• Public awareness campaigns are a partial success.
• It is imperative for the physician to allocate time to address the importance of lifestyle modification efforts.
• The genetic basis of CAD is being unraveled at an accelerated pace.
• The future genetic assessment of a person’s lifetime risk for developing atherosclerotic vascular disease, formerly an idea, is now emerging as a reality.
• These findings can guide lifestyle modification, prescription, and the choice and dosage of specific pharmaceuticals.
• A preemptive approach is the best way to tackle the immensity of CAD.
• We must erase the myth that medications, stenting, and bypass surgery are curative approaches. Instead, the patient must meet the healthcare team at least halfway to achieve a successful health outcome.

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