Treatment and Prevention of Coronary Artery Disease

One should bear in mind that ischemic heart disease is a condition that progresses slowly. Thus, it is critical to detect the disease at its early stages.

The treatment of this disorder employs the following measures:

1. Therapy without the use of drugs
   The patient diagnosed with CAD is provided with a plan for changing his lifestyle and eliminating (or reducing to a minimum) all risk factors. The patient plan may include:
   • Give up smoking and excessive alcohol consumption;
   • Switch to a low-calorie nutritious diet that provides a normal level of cholesterol;
   • Enrich the diet with specific vitamins and minerals;
   • Incremental increase of physical activity;
   • Avoid stresses;
   • Lose excess weight;
   • Monitor blood pressure.
2. Pharmacological treatment
   
   This type of therapy involves various medicinal products:
   • Anti-clotting agents – thin the blood, which facilitates blood flow, to prevent the formation of blood clots, and reduce platelet aggregation;
   • Beta-blockers – reduce heart contraction rate which enable the heart to receive required amount of oxygen;
   • Statins and fibrates – used to reduced blood cholesterol level;
   • Nitrates – relieve angina attacks. The vasodilatory effect facilitates blood flow;
   • Diuretics – intended to increase water excretion from the body, which significantly reduces the load on the heart muscle;
   • ACE inhibitors – lower blood pressure.
   It is vital for the quality and extension of a patient’s life that he follow the healthy heart plan customized by his physician.
   
   
3. Surgical intervention
   • Balloon angioplasty and stenting performed under local anesthesia. The whole procedure is performed under X-ray control. A catheter with a balloon and a stent at its top is inserted into an artery and guided towards the heart. When the restricted area of the artery is reached, a stent is placed which serves as a skeleton supporting the walls of the vessel.
     
     
   • Coronary artery bypass grafting – the creation of alternative channels for the heart muscle blood supply to bypass the coronary arteries affected with atherosclerosis. The material for the alternative routes is made of the patient’s vein taken from under the skin of his thigh.
4. Other methods of treatment that do not involve the use of drugs:
   • Leech therapy – this method of treatment is based on the antiplatelet properties of the medicinal leech saliva. It is an alternative method of therapy and has not been clinically tested. Potential positive effects of this method consist in the prevention of thrombosis;
     
     
   • Shock-wave therapy – uses acoustic (shock) waves. The influence of the low-energy shock waves causes the restoration of the vessels in heart muscles and improvement of the blood flow;
     
     
   • Stem cell therapy – when stem cells are introduced into the body, it is expected that they differentiate into the missing cells of heart muscles or the outermost layer of the vessel walls. The World Health Organization views the method as promising, however, it has yet to recommend it for practical application;
     
     
   • Enhanced external counter-pulsation therapy (EECP) – a non-invasive method of CAD treatment. It improves coronary blood flow by means of counter-pulsation using unique pneumatic cuffs on the patient’s legs. These cuffs inflate and deflate to facilitate physiological at the starts of diastole and deflate at the start of systole, thus improving physiological filling of coronary vessels with blood.

The course of coronary heart disease is irreversible. Modern methods of CAD treatment allow a greater or lesser control degree of the disease as well as help slow its progression, but they cannot reverse the process.