Medical therapy versus percutaneous coronary interventions for patients with stable and unstable coronary artery disease

The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial has evoked renewed and intense discussion as to whether to recommend medical therapy or coronary revascularization for patients with coronary artery disease (CAD), especially in those patients with stable CAD who are at low to intermediate risk for future cardiovascular events. The decision in regard to the timing and role of revascularization in patients with unstable CAD, although still evolving, is somewhat less controversial. The major focus of this discussion is, therefore, on the patient with stable CAD.