Chronic coronary artery disease

© 2009 Mayo Foundation for Medical Education and Research Chronic coronary artery disease (CAD) is estimated to affect 16.8 million people in the United States; of these, 9.8 million have angina pectoris, and nearly 8 million have had a myocardial infarction (MI). In 2005, CAD was the single most frequent cause of death in American men and women, causing 607,000 deaths (about 1 in every 5 deaths). In 2006, 1.76 million patients were discharged from US hospitals with a diagnosis of CAD. The estimated direct and indirect economic cost of CAD in the United States for 2009 is $165.4 billion. Worldwide, cardiovascular disease is becoming pandemic as developing countries experience the epidemiologic transition described by Omran from pestilence and famine to receding pandemics and degenerative diseases. In 2002, out of 57 million deaths worldwide, apOn completion of this article, you should be able to: (1) integrate the information obtained from a history, physical examination, and a stress test to diagnose and stratify the risk of patients with chronic coronary artery disease; (2) apply evidencebased management strategies to improve survival in patients with chronic coronary artery disease; and (3) determine when revascularization is indicated in a patient with chronic coronary artery disease, and, if indicated, choose the preferred method for each patient. Chronic Coronary Artery Disease: Diagnosis and Management