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Case report
Total angiographic regression of coronary atherosclerosis with optimal medical therapy
  1. Kudel Kunhali1 and
  2. Robin George Manappallil2
  1. 1Cardiology, Dr Kunhali’s Heart Care Center, Calicut, Kerala, India
  2. 2Internal Medicine, Baby Memorial Hospital, Calicut, Kerala, India
  1. Correspondence to Dr Robin George Manappallil; drrobingeorgempl{at}gmail.com

Abstract

Coronary artery disease has shown a dramatic increase worldwide. According to the current guidelines, optimal medical therapy (OMT) is recommended as the first-line treatment for stable angina; with revascularisation being reserved for those with persistent or progressive symptoms despite intensive medical therapy. We report the case of a young man with stable angina, who was advised percutaneous coronary intervention for stenosis of left anterior descending artery. As he was not willing for the same, he was treated with OMT (according to the then relevant Adult Treatment Panel (ATP) III guidelines) and therapeutic lifestyle changes, following which he became asymptomatic along with total regression of the atherosclerotic plaque on coronary angiogram. This case highlights that OMT can be an effective line of management in patients with stable angina; and interventions like angioplasty, stents and surgery may be reserved for those who do not respond adequately.

  • ischaemic heart disease
  • interventional cardiology
  • optimal medical therapy

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Footnotes

  • Contributors KK: critical revision of manuscript and treating cardiologist. RGM: concept and design, manuscript preparation, review of literature and treating physician.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed