How To Treat Coronary Artery Disease (CAD)

Coronary artery disease (CAD) occurs when there's a blockage in the arteries that carry blood and oxygen to the heart muscle. CAD is the most common type of heart disease in the United States and a major contributor to heart attacks and deaths.

While this is a lifelong condition, there are effective treatments that help reduce symptoms, prevent complications, and promote heart health. Treatments often include medications, lifestyle changes, and surgery.

Medications

Cardiologists, or doctors who specialize in heart conditions, are the primary healthcare providers involved in treating coronary artery disease. Your provider may prescribe medications to help reduce symptoms. While medications may always carry the risk of possible side effects, there are several options to choose from.

Medications used to treat CAD include:

• Antiplatelet medications: Bayer (aspirin), Plavix (clopidogrel), Effient (prasugrel), and Brilinta (ticagrelor) are blood thinners. If you have a stent, you'll typically need these medications to help keep it open. After some time, your cardiologist may ask you to stop one of the antiplatelets.
• Statins: Medications such as Lipitor (atorvastatin) or Crestor (rosuvastatin) effectively lower cholesterol and heart disease risk. Serious side effects are rare, but if you experience them, other medications can also help reduce cholesterol.
• Beta-blockers: Lopressor (metoprolol) or Coreg (carvedilol) can help manage chest discomfort from CAD and treat related heart failure. Beta-blockers lower your heart rate, and fatigue is a common side effect.
• Angiotensin-converting enzyme (ACE) inhibitors: These drugs treat hypertension and heart failure associated with CAD by dilating the blood vessels and lowering blood pressure.
  

Lifestyle Changes

Several lifestyle habits can help lower your chance of developing coronary artery disease and your risk of CAD complications. To keep your heart as healthy as possible, the American Heart Association recommends the following lifestyle habits:

• Avoid smoking
• Avoid secondhand smoke
• Eat a heart-healthy diet rich in fruits, vegetables, fiber, whole grains, fish, and lean meats
• Limit intake of salt, ultra-processed foods, sugary drinks, and alcohol
• Aim for 150 minutes of moderate-intensity exercise per week, such as brisk walking
• Get 7-9 hours of sleep per night
• Monitor your blood sugar, cholesterol, and blood pressure

According to public health guidelines, people with CAD should also receive the flu and COVID-19 vaccines to prevent complications from these respiratory illnesses.

Surgery and Procedures

In addition to medication and lifestyle habits, a cardiologist will sometimes recommend a procedure or surgery to open up a blocked vessel. There are two main options: percutaneous coronary intervention or coronary artery bypass grafting.

Percutaneous Coronary Intervention

Percutaneous coronary intervention (PCI) is a minimally invasive procedure to open blocked arteries using a stent. In this procedure, a cardiologist places a catheter in an artery in the wrist or groin. Using contrast dye and X-rays, they can visualize the heart's arteries. They then open a blockage by inflating a balloon and placing a stent to keep the artery open.

Cardiologists often perform PCI as an emergency treatment for a heart attack when a sudden blockage reduces blood flow to the heart. It's also used when people have persistent chronic angina (chest discomfort due to heart blockages) despite medical treatment.

Coronary Artery Bypass Grafting

Coronary artery bypass grafting surgery (CABG) is a surgery in which a cardiac surgeon bypasses the blocked coronary artery. The surgeon sews a piece of artery or vein from elsewhere in the body (e.g., chest, leg, arm) above and below the blockage to create a new route for blood flow. This is a more invasive procedure that carries some risks, and a cardiologist and heart surgeon can help determine if it's an appropriate option for you.

Prognosis and Life Expectancy

Coronary artery disease is a lifelong condition that can increase your risk of heart attack, stroke, and early death. The prognosis and life expectancy of CAD depend on age, symptom severity, underlying conditions, heart function, and overall health status.

In a registry of people who had undergone coronary angiography (a minimally invasive procedure looking at the coronary arteries), the 12-year survival rate of those with normal coronary arteries was 91%. Those with blockages in one vessel had a 74% survival rate, whereas the 12-year survival rate was 50% for people with blockages in three vessels.

Many people with CAD can live long, active, and healthy lives. Treatment and lifestyle habits can help lower the risk of complications and premature death.

Living With and Managing CAD

Coronary artery disease is a very common condition in the United States, but it can affect your daily life by causing symptoms that limit your activity and energy levels. Getting a diagnosis of heart disease isn't easy, and it affects many people's mental health. If you're experiencing mood changes like anxiety and depression as you process your diagnosis, therapy is available to help you cope.

If you have difficulty managing CAD or could use some motivation to make lifestyle changes and adhere to your treatment plan, your healthcare team is available for support. Staying in contact with your providers and leaning on your loved ones is an important part of the treatment journey.

There are also support groups that you can reach out to for help, such as:

• Mended Hearts
• American Heart Association Go Red for Women
• American Heart Association Support Network

Cardiac rehab is also a great way to learn how to safely exercise and get tips on managing CAD. This intensive therapy program includes monitored exercise, education, and counseling to help you live a healthy life with CAD or other heart conditions.

Regardless of which treatments you and your provider choose, living well with CAD is still possible. Following your treatment plan, making necessary lifestyle changes, and asking for support when you need it are essential.