Background: In the last decade percutaneous transluminal coronary angioplasty has become a very popular strategy for the treatment of coronary artery disease, although its efficacy in reducing ischemic events and the subsequent need for revascularization has yet to be proved.
Methods: We reviewed the latest trials that compared percutaneous transluminal coronary angioplasty and medical therapy.
Results: We discuss the potentially favorable effect of lipid-lowering therapy on coronary atherosclerosis and cardiac events and comment on the results of the recent Atorvastatin Versus Revascularization Treatments (AVERT) study that compared lipid-lowering treatment and percutaneous transluminal coronary angioplasty in patients with stable coronary artery disease.
Conclusions: Medical treatment aimed at reversing plaque growth and promoting plaque stabilization should probably be considered as the initial therapeutic option. Statin class drugs, together with aggressive management of known risk factors, show promise as the first step after appropriate early diagnosis. Revascularization procedures should subsequently be considered for all patients who do not respond to medical treatment or in whom the disease shows clear signs of progression.