No present treatment can cure Coronary Artery Disease!
They include the following types of medications, that:
- Thin your blood,
- Slow your heart down, so that less demand matches limited blood supply,
- Relax (dilate) your arteries so that more blood can pass through a wider pathway,
- Lower your blood pressure so that the heart has to work less,
- Modify your cholesterol to control the build-up of plaque (blockage),
- It also includes lifestyle modifications (diet, exercise and weight loss, smoking).
The diseases that cause CAD are determined by your genes, diet, smoking and your environment. Treatments all have the same goals: to improve quality of life and to alleviate symptoms by balancing the supply and demand of blood to the heart. Medical treatments, diet and exercise may also delay or stop the progression of the disease and thereby prolong life. However, there are some important differences between medications and life style modification on the one hand and procedures on the other.
Procedures are usually more beneficial than medical treatment when there are severe blockages (stenoses) and/or when many coronary arteries are involved, or when the left main coronary artery (the artery that supplies blood to the left side of the heart) is narrowed.
Bloodthinners and Anti Platelet drugs
Anti Platelet drugs
In Individuals at low absolute risk of a first CAD event, the use of Aspirin has a clinically important reduction in risk of myocardial infarction, weighed against the risk of bleeding. The risks and benefits of aspirin therapy vary for each person.Anticoagulant DrugsAnticoagulants inhibit the ability of blood to clot, or coagulate. They don’t dissolve existing blood clots. They prevent new clots from forming or existing clots from getting larger. The most common use of anticoagulation is in people with a heart arrhythmia called atrial fibrillation. Most people with atrial fibrillation should take warfarin (Coumadin®) or a new drug, Dabigatran. At low doses, inhibits platelet generation of thromboxane A2 and leads to antithrombotic effect. At medium doses, it inhibits COX-1 and COX-2 by blocking the prostaglandin production and has analgesic and antipyretic effects. ASA at high doses is effective as an anti-inflammatory drug in treating rheumatic disorders.
Clopidogrel is a thienopyridine ADP-receptor antagonist that irreversibly binds to the P2Y12 receptor. Clopidogrel, administered by mouth once a day, may have variable responses and has a delayed onset of action from 2 to 6 hours if given as a loading dose of 600 mg and 12 to 24 hours if used at a 300-mg dose.There are concerns about decreased efficacy if clopidogrel is administered in poor metabolizers, specifically with the CYP2C19*2 or CYP2C19*3 alleles. However, genetic testing is not widely used and not currently recommended. It may be considered for some patients, and dosing recommendations have not been determined in patients with poor metabolizers. This raises the issue of drug interaction if used with proton-pump inhibitors (PPIs).
Dipyridamole inhibits the activity of adenosine deaminase and phosphodiesterase, which causes an accumulation of adenosine, adenine nucleotides, and cyclic adenosine monophosphate. It further inhibits platelet aggregation and leads to vasodilation. Dipyridamole is usually used in conjunction with other anticoagulants to prevent thromboembolic complications after surgery. The downside of using dipyridamle is inconvenience, partially because of multiple doses administered by mouth per day. Dipyridamole is also available in combination with ASA under the brand name Aggrenox and is used to reduce the risk of stroke. Aggrenox is usually administered twice daily. Dipyridamole is also used as a stress test agent.
Diuretics help the body get rid of excess sodium (salt) and water and help control blood pressure. They are often used in combination with additional prescription therapies.
Medications that slow your heart down
Drugs that relax (dilate) your arteries & lower your blood pressure
Various medications can lower blood cholesterol levels.
This class of drugs works in the liver to prevent the formation of cholesterol. Statins are most effective at lowering the LDL (bad) cholesterol, but also have modest effects on lowering triglycerides (blood fats) and raising HDL (good) cholesterol.
Selective cholesterol absorption inhibitors or Resins (also known as bile acid sequestrant or bile acid-binding drugs)
This class of cholesterol-lowering (LDL) medications works by preventing the absorption of cholesterol from the intestine and by promoting increased disposal of cholesterol.
Fibrates are best at lowering triglycerides and in some cases increasing HDL (good cholesterol) levels. .
This drug works in the liver by affecting the production of blood fats.