Indicated to reduce the risk of myocardial infarction (MI), stroke, coronary revascularization, and cardiovascular death in patients with atherosclerotic disease or with multiple risk factors for cardiovascular disease.2026-05-22

Upcoming trial readoutImportant

One Month Dual Antiplatelet Therapy With Ticagrelor in Coronary Artery Bypass Graft Patients

Results expected Q1 20272025-12-22

Upcoming trial readoutImportant

The Impact of Pcsk-9 Inhibition on PET Coronary Flow Reserve in Patients at High Cardiovascular Risk (EMPOWER Study)

Results expected Q1 20272025-11-04

Clinical Milestones3View

Results expected 3

2026-01-22International, Multicenter, Investigator-driven Randomized Clinical Trial to Assess the Single vs. Dual Antiplatelet Therapy in Elderly or HBR Patients Undergoing Percutaneous Intervention With Drug-coated Balloons (PICCOLETO IV-EPIC 38)Results expected Q1 2028
2025-12-22One Month Dual Antiplatelet Therapy With Ticagrelor in Coronary Artery Bypass Graft PatientsResults expected Q1 2027
2025-11-04The Impact of Pcsk-9 Inhibition on PET Coronary Flow Reserve in Patients at High Cardiovascular Risk (EMPOWER Study)Results expected Q1 2027

Regulatory Updates1View

2026-05-22CHMP positive opinion — ColchicineIndicated to reduce the risk of myocardial infarction (MI), stroke, coronary revascularization, and cardiovascular death in patients with atherosclerotic disease or with multiple risk factors for cardiovascular disease.

Activity timeline4

2026-05-22RegulatoryCHMP positive opinion — ColchicineIndicated to reduce the risk of myocardial infarction (MI), stroke, coronary revascularization, and cardiovascular death in patients with atherosclerotic disease or with multiple risk factors for cardiovascular disease.
2026-01-22ClinicalInternational, Multicenter, Investigator-driven Randomized Clinical Trial to Assess the Single vs. Dual Antiplatelet Therapy in Elderly or HBR Patients Undergoing Percutaneous Intervention With Drug-coated Balloons (PICCOLETO IV-EPIC 38)Results expected Q1 2028
2025-12-22ClinicalOne Month Dual Antiplatelet Therapy With Ticagrelor in Coronary Artery Bypass Graft PatientsResults expected Q1 2027
2025-11-04ClinicalThe Impact of Pcsk-9 Inhibition on PET Coronary Flow Reserve in Patients at High Cardiovascular Risk (EMPOWER Study)Results expected Q1 2027

Therapeutic landscape

Therapies with a regulatory footing for this condition, alongside the wider set of agents co-studied with it in the literature.

Approved & established therapies

Rivaroxabanapproved

Approval — Rivaroxaban Mylan co-administered with acetylsalicylic acid (ASA) alone or with ASA plus… (2021)

Ivabradine hydrochlorideapproved

Approval — Symptomatic treatment of chronic stable angina pectoris Ivabradine is indicated for the s… (2017)

Cangrelorapproved

Approval — Kengrexal, co-administered with acetylsalicylic acid (ASA), is indicated for the reductio… (2015)

Clopidogrelapproved

Approval — Secondary prevention of atherothrombotic events Clopidogrel is indicated in: Adult patie… (2015)

Ivabradineapproved

Approval — Symptomatic treatment of chronic stable angina pectoris Ivabradine is indicated for the s… (2015)

Telmisartanapproved

Approval — Hypertension Treatment of essential hypertension in adults. Cardiovascular prevention Red… (2010)

Clinical trials

18 sponsors · 1 new · 0 completed in the last 12 months (net +1)

The current development programme across all trial phases.

Clinical programme

All trials

Active

Late-stage

Completed

Late-stage studies

One Month Dual Antiplatelet Therapy With Ticagrelor in Coronary Artery Bypass Graft Patients

Phase 3 · Recruiting · Weill Medical College of Cornell University

The Impact of Pcsk-9 Inhibition on PET Coronary Flow Reserve in Patients at High Cardiovascular Risk (EMPOWER Study)

Phase 4 · Recruiting · Brigham and Women's Hospital

High Dose Atorvastatin Raises Threshold of Contrast Induced Nephropathy in Diabetic Patients Undergoing Elective Coronary Intervention

Phase 4 · Completed · Mohamed Abdelfatah

Effects of LMWH Versus Dabigatran on Platelet Aggregation in Patients With Stable Coronary Artery Disease

Phase 4 · Completed · University of Sao Paulo General Hospital

Randomized, Multinational, Double-blind Study, Comparing a High Loading Dose Regimen of Clopidogrel Versus Standard Dose in Patients With Unstable Angina or Myocardial Infarction Managed With an Early Invasive Strategy.

Phase 3 · Completed · Sanofi

Stress Testing and Cardiac Magnetic Resonance

Phase 4 · Completed · University of Chicago

Recruiting

One Month Dual Antiplatelet Therapy With Ticagrelor in Coronary Artery Bypass Graft Patients

Phase 3 · Recruiting · Weill Medical College of Cornell University

The Impact of Pcsk-9 Inhibition on PET Coronary Flow Reserve in Patients at High Cardiovascular Risk (EMPOWER Study)

Phase 4 · Recruiting · Brigham and Women's Hospital

A Healthy Nordic Diet to Reduce the Progression of Atherosclerosis in Individuals with Coronary Heart Disease: a Secondary Prevention Trial

N/A · Recruiting · Uppsala University

International, Multicenter, Investigator-driven Randomized Clinical Trial to Assess the Single vs. Dual Antiplatelet Therapy in Elderly or HBR Patients Undergoing Percutaneous Intervention With Drug-coated Balloons (PICCOLETO IV-EPIC 38)

N/A · Recruiting · Fondazione Ricerca e Innovazione Cardiovascolare ETS

Patient Blood Manegement (PBM) as Perioperative Strategy to Anemic Patients Who Will be Submitted to Coronary Artery Bypass Graft (CABG).

Phase 2 · Recruiting · Federal University of São Paulo

Recently completed

High Dose Atorvastatin Raises Threshold of Contrast Induced Nephropathy in Diabetic Patients Undergoing Elective Coronary Intervention

Phase 4 · Completed · Mohamed Abdelfatah

Effects of LMWH Versus Dabigatran on Platelet Aggregation in Patients With Stable Coronary Artery Disease

Phase 4 · Completed · University of Sao Paulo General Hospital

Stress Testing and Cardiac Magnetic Resonance

Phase 4 · Completed · University of Chicago

Clinical Assessment of Pidogrel® Versus Plavix®

Phase 4 · Completed · Les Laboratoires des Médicaments Stériles

A Prospective, Double-blinded, Randomised Study to Evaluate the Effects of Different Doses of Statin Treatment on Plaque Volume and Composition in Coronary Disease Determined by Virtual Histology Using Intravascular Ultrasound

Phase 4 · Completed · Prof. Stephen Lee

Phase 3 · Completed · Sanofi

Regulatory timeline

Drug regulatory events matched to this condition by indication — EMA.

First approvals

2021emaApproval — Rivaroxaban· Rivaroxaban Mylan co-administered with acetylsalicylic acid (ASA) alone or with ASA plus clopidogrel or ticlopidine, is indicated for the prevention of atherothrombotic events in adult patients after an acute coronary syndrome (ACS) with elevated cardiac biomarkers.  Rivaroxaban Mylan co-administered with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with coronary artery disease (CAD) or symptomatic peripheral artery disease (PAD) at high risk of ischaemic events.  ------ Prevention of venous thromboembolism (VTE) in adult patients undergoing elective hip or knee replacement surgery.  Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults. ------- Adults  Prevention of stroke and systemic embolism in adult   patients with non-valvular atrial fibrillation with one or more risk factors, such as congestive heart failure, hypertension, age ? 75 years, diabetes mellitus, prior stroke or transient ischaemic attack. Paediatric population  Treatment of venous thromboembolism (VTE) and prevention of VTE recurrence in children and adolescents aged less than 18 years and weighing from 30 kg to 50 kg after at least 5 days of initial parenteral anticoagulation treatment. Paediatric population  Treatment of venous thromboembolism (VTE) and prevention of VTE recurrence in children and adolescents aged less than 18 years and weighing more than 50 kg after at least 5 days of initial parenteral anticoagulation treatment.   source ↗

2020emaApproval — Rivaroxaban· Prevention of venous thromboembolism (VTE) in adult patients undergoing elective hip or knee replacement surgery. Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults. (See section 4.4 for haemodynamically unstable PE patients. Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults. (See section 4.4 for haemodynamically unstable PE patients). Adults Prevention of stroke and systemic embolism in adult patients with non valvular atrial fibrillation with one or more risk factors, such as congestive heart failure, hypertension, age ? 75 years, diabetes mellitus, prior stroke or transient ischaemic attack. Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults. (See section 4.4 for haemodynamically unstable PE patients.) Paediatric population Treatment of venous thromboembolism (VTE) and prevention of VTE recurrence in children and adolescents aged less than 18 years and weighing from 30 kg to 50 kg after at least 5 days of initial parenteral anticoagulation treatment. Rivaroxaban Accord, co administered with acetylsalicylic acid (ASA) alone or with ASA plus ticlopidine, is indicated for the prevention of atherothrombotic events in adult patients after an acute coronary syndrome (ACS) with elevated cardiac biomarkers (see sections 4.3, 4.4 and 5.1). Rivaroxaban Accord, co administered with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with coronary artery disease (CAD) or symptomatic peripheral artery disease (PAD) at high risk of ischaemic events. Adults Prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation with one or more risk factors, such as congestive heart failure, hypertension, age ? 75 years, diabetes mellitus, prior stroke or transient ischaemic attack. Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults. (See section 4.4 for haemodynamically unstable PE patients.) Paediatric population Treatment of venous thromboembolism (VTE) and prevention of VTE recurrence in children and adolescents aged less than 18 years and weighing more than 50 kg after at least 5 days of initial parenteral anticoagulation treatment. source ↗

2017emaApproval — Ivabradine hydrochloride· Symptomatic treatment of chronic stable angina pectoris Ivabradine is indicated for the symptomatic treatment of chronic stable angina pectoris in coronary artery disease adults with normal sinus rhythm and heart rate ? 70 bpm. Ivabradine is indicated : - in adults unable to tolerate or with a contra-indication to the use of beta-blockers - or in combination with beta-blockers in patients inadequately controlled with an optimal beta-blocker dose. Treatment of chronic heart failure Ivabradine is indicated in chronic heart failure NYHA II to IV class with systolic dysfunction, in patients in sinus rhythm and whose heart rate is ? 75 bpm, in combination with standard therapy including beta-blocker therapy or when beta-blocker therapy is contraindicated or not tolerated. (see section 5.1) source ↗

2016emaApproval — Ivabradine hydrochloride· Symptomatic treatment of chronic stable angina pectoris Ivabradine is indicated for the symptomatic treatment of chronic stable angina pectoris in coronary artery disease adults with normal sinus rhythm and heart rate ? 70 bpm. Ivabradine is indicated: in adults unable to tolerate or with a contra-indication to the use of beta-blockers or in combination with beta-blockers in patients inadequately controlled with an optimal beta-blocker dose. Treatment of chronic heart failure Ivabradine is indicated in chronic heart failure NYHA II to IV class with systolic dysfunction, in patients in sinus rhythm and whose heart rate is ? 75 bpm, in combination with standard therapy including beta-blocker therapy or when beta-blocker therapy is contraindicated or not tolerated. source ↗

2015emaApproval — Ivabradine· Symptomatic treatment of chronic stable angina pectoris Ivabradine is indicated for the symptomatic treatment of chronic stable angina pectoris in coronary artery disease adults with normal sinus rhythm and heart rate ? 70 bpm. Ivabradine is indicated: in adults unable to tolerate or with a contra-indication to the use of beta-blockers or in combination with beta-blockers in patients inadequately controlled with an optimal betablocker dose. Treatment of chronic heart failure Ivabradine is indicated in chronic heart failure NYHA II to IV class with systolic dysfunction, in patients in sinus rhythm and whose heart rate is ? 75 bpm, in combination with standard therapy including beta-blocker therapy or when beta-blocker therapy is contraindicated or not tolerated. source ↗

2015emaApproval — Cangrelor· Kengrexal, co-administered with acetylsalicylic acid (ASA), is indicated for the reduction of thrombotic cardiovascular events in adult patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) who have not received an oral P2Y12 inhibitor prior to the PCI procedure and in whom oral therapy with P2Y12 inhibitors is not feasible or desirable. source ↗

2015emaApproval — Clopidogrel· Secondary prevention of atherothrombotic events Clopidogrel is indicated in: Adult patients suffering from myocardial infarction (from a few days until less than 35 days), ischaemic stroke (from 7 days until less than 6 months) or established peripheral arterial disease. Adult patients suffering from acute coronary syndrome: Non-ST segment elevation acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction), including patients undergoing a stent placement following percutaneous coronary intervention, in combination with acetylsalicylic acid (ASA). ST segment elevation acute myocardial infarction, in combination with ASA in medically treated patients eligible for thrombolytic therapy. Prevention of atherothrombotic and thromboembolic events in atrial fibrillationIn adult patients with atrial fibrillation who have at least one risk factor for vascular events, are not suitable for treatment with Vitamin K antagonists (VKA) and who have a low bleeding risk, clopidogrel is indicated in combination with ASA for the prevention of atherothrombotic and thromboembolic events, including stroke. source ↗

2010emaApproval — Telmisartan· Hypertension Treatment of essential hypertension in adults. Cardiovascular prevention Reduction of cardiovascular morbidity in patients with: manifest atherothrombotic cardiovascular disease (history of coronary heart disease, stroke, or peripheral arterial disease) or; type 2 diabetes mellitus with documented target organ damage. source ↗

Other regulatory activity

2026emaCHMP positive opinion — Colchicine· Indicated to reduce the risk of myocardial infarction (MI), stroke, coronary revascularization, and cardiovascular death in patients with atherosclerotic disease or with multiple risk factors for cardiovascular disease. source ↗

European Medicines Agency (CC BY 4.0). Events are matched to this condition by drug indication text — approvals/updates for drugs indicated for it, not disease-specific acts.

Research activity

30 papers

Key research shaping understanding of this disease, combining the latest publications with the most influential evidence.

Publications over time

20062024

Most influential

The MR-Base platform supports systematic causal inference across the human phenome.

eLife · 2018 · 6,312 cites

Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.

The New England journal of medicine · 1998 · 3,271 cites

Mendelian Randomization.

JAMA · 2017 · 2,773 cites

A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization.

The New England journal of medicine · 2002 · 2,660 cites

Guidelines on the management of valvular heart disease (version 2012).

European heart journal · 2012 · 2,371 cites

Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study.

Circulation · 2007 · 2,170 cites

Recent publications

Association of Cannabis Use With Cardiovascular Outcomes Among US Adults.

Journal of the American Heart Association · 2024 · 115 cites

Circulation · 2023 · 872 cites

Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis.

European heart journal · 2023 · 256 cites

Risk of incident cardiovascular disease in people with periodontal disease: A systematic review and meta-analysis.

Clinical and experimental dental research · 2021 · 86 cites

Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis.

BMJ (Clinical research ed.) · 2020 · 483 cites

Genetic drug target validation using Mendelian randomisation.

Nature communications · 2020 · 396 cites

Major themes8

Coronary Disease4
Mendelian Randomization Analysis3
Myocardial Infarction2
Stroke2
Algorithms1
American Heart Association1
Cannabis1
Cardiac Rehabilitation1

Leading journals6

Circulation8
The New England journal of medicine7
European heart journal5
BMJ (Clinical research ed.)2
JAMA2
Annals of internal medicine1

Leading researchers8

Grundy SM3
Assmann G2
Blair SN2
Colombo A2
Greenland P2
Hong Y2
Mark DB2
Schuler G2

Affiliations (unnormalised)6

University of Cambridge2
Affiliated Hospital of Guangdong Medical University1
AHA/ACC Joint Committee on Clinical Data Standards.1
Albert Einstein College of Medicine1
American College of Clinical Pharmacy representative.1
Amsterdam Public Health Research Institute1

Disease biology

1 match

Key proteins & gene products studied in this disease. Number shows shared papers.

Cholesterol, LDL2

Related conditions

12 matches

Diseases frequently studied alongside this one. Number shows shared papers.

Cardiovascular Diseases8 Stroke7 Myocardial Infarction5 Hypertension4 Death, Sudden, Cardiac3 Arrhythmias, Cardiac2 Arteriosclerosis2 Atherosclerosis2 Coronary Artery Disease2 Diabetes Mellitus2 Heart Diseases2 Myocardial Ischemia2

Disease profile

A grounded synthesis of the condition — overview, causes, mechanism, risk factors and current standard of care.

Overview

Coronary disease is an imbalance between the heart muscle’s functional needs and the ability of the coronary vessels to deliver enough blood flow. It is a form of myocardial ischemia caused by reduced capacity of the coronary vessels to supply the myocardium.

Causes

The grounding supports coronary disease as being caused by decreased capacity of the coronary vessels, but does not provide a more specific aetiology. The literature supplied also links coronary heart disease prevention and management to familial hypercholesterolaemia and blood pressure-related cardiovascular risk, but not as direct causes of the disease in this grounding.

Pathophysiology

The core mechanism is myocardial ischemia from insufficient coronary blood flow relative to myocardial demand. The supplied literature also emphasizes atherosclerotic plaque vulnerability and thrombotic complications as important contributors to coronary heart disease events, consistent with impaired coronary perfusion.

Risk factors

The supplied grounding supports familial hypercholesterolaemia, elevated LDL cholesterol, smoking, and higher blood pressure as factors associated with coronary heart disease risk. It also supports prediabetes as being associated with increased cardiovascular disease risk, and exercise is discussed in the context of rehabilitation rather than as a risk factor.

Current standard of care

The supplied guideline and review abstracts support chronic coronary disease management and exercise-based cardiac rehabilitation as treatment modalities. They also support preventive and risk-reduction approaches using blood pressure-lowering drugs and lipid-lowering management for familial hypercholesterolaemia to prevent coronary heart disease.

AI-generated summary grounded in MeSH and 6 peer-reviewed sources. Informational only — not medical advice. Generated 2026-07-07.

Reference

Authoritative identity, definition & identifiers.

Defined in MeSH

An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.

Identifiers

MeSHCoronary Disease

References & data sources

Disease identity & definition — NLM Medical Subject Headings (MeSH), public domain
Clinical trials — ClinicalTrials.gov (U.S. National Library of Medicine)
Research activity — Europe PMC (EMBL-EBI) + OpenAlex-derived paper links
Related entities are derived from literature co-mention (studied together) — associative, not causal.