"Can coronary artery disease (CAD) be cured?"

If the patient has very high cholesterol, aggressive treatment with cholesterol lowering agents have clearly shown quite significant reduction in the incidence of myocardial infarction (up to 34% reduction of MI). The overall mortality rate is also reduced by 30%. In addition, a 37% reduction is noted in revascularization procedures such as open-heart surgery and PTCA. The famous Simvastatin Survival Study (4S Study-Merck 1994), which showed the aforementioned beneficial effects with cholesterol reduction have revolutionized the treatment of patients with hypercholesterolemia. Similar beneficial effects have also been observed with Pravachol (Bristol-Myers Squibb). In some patients with documented coronary atherosclerosis and hypercholesterolemia, aggressive reduction of cholesterol has shown some resolution in the atherosclerotic process, and reduction in the degree of coronary stenosis. However, the short-term effect of these medications is to passivate the cholesterol plaque with its anti-inflammatory properties, thereby reducing the chance of erosion and rupture.

Thus, the natural history of CAD can be modified. In some instances, the degree of the lesion can be reversed, and the complications can be reduced. However, atherosclerosis is considered to be a permanent affliction once it has occurred.