Condition

Coronary Artery Disease

Narrowing or blockage of coronary arteries

250M
People Affected
300
Active Trials
5M
New Cases/Year
9M
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Lifestyle Modifications (Diet, Exercise, Smoking Cessation)
90% Effectiveness• 90% Confidence• 95% Safety• 2 trials• 5M participants
HIGH EvidenceExcellent ValueDose: Exercise: 150 mins moderate intensity/week; Diet: Mediterranean/DASH; Smoking Cessation: Complete abstinence
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
95
DangerousModerateSafe

Time to Effect

immediate for some benefits, 6-12 months for sustained cardiovascular protection

Duration

lifetime

Response Rate

30%

Remission Rate

5%

Number Needed to Treat (NNT)

30

Number Needed to Harm (NNH)

100000

Common Side Effects:

Musculoskeletal injury (from exercise): 5%
Nicotine withdrawal symptoms (if smoking cessation): 30%
Difficulty adhering to dietary changes: 20%

Annual Cost of Care

Drug Cost

$0

Monitoring

$300

Side Effects

$20

Total Annual

$320

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.7

ICER

$-5,000/QALY

Cost per Remission

$6,400

Cost per Responder

$1,067

Treatment Outcomes
Primary Outcomes
LDL Cholesterol130 mg/dL
-18% (-23.4 mg/dL)
Systolic Blood Pressure140 mmHg
-7% (-9.8 mmHg)
Diastolic Blood Pressure90 mmHg
-8% (-7.2 mmHg)
Angina Frequency (Seattle Angina Questionnaire)SAQ Angina Frequency Score: 50/100
+20% (+10 points)
Body Mass Index (BMI)BMI 30 kg/m²
-7% (-2.1 kg/m²)
Secondary Benefits
HDL Cholesterol40 mg/dL
+7.5% (+3.0 mg/dL)
Triglycerides180 mg/dL
-25% (-45.0 mg/dL)
HbA1c6.8%
-5.9% (-0.4%)
Common Side Effects
Musculoskeletal injury (from exercise)
+5%
Nicotine withdrawal symptoms (if smoking cessation)
+30%
Difficulty adhering to dietary changes
+20%

Clinical Trial Phases:

Phase 4
2
Statins (e.g., Atorvastatin)
88% Effectiveness• 95% Confidence• 65% Safety• 1 trials• 1M participants
HIGH EvidenceExcellent ValueDose: Atorvastatin: 10-80mg daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

6-12 months for cardiovascular event reduction

Duration

lifetime

Response Rate

30%

Remission Rate

%

Number Needed to Treat (NNT)

25

Number Needed to Harm (NNH)

10000

Common Side Effects:

Myalgia (muscle pain): 8%
Elevated liver enzymes: 2%
New-onset diabetes: 0.5%

Annual Cost of Care

Drug Cost

$40

Monitoring

$150

Side Effects

$50

Total Annual

$240

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.3

ICER

$15,000/QALY

Cost per Responder

$800

Treatment Outcomes
Primary Outcomes
LDL Cholesterol120 mg/dL
-45% (-54 mg/dL)
Total Cholesterol200 mg/dL
-30% (-60 mg/dL)
Triglycerides180 mg/dL
-15% (-27 mg/dL)
High-Sensitivity C-Reactive Protein (hs-CRP)3 mg/L
-20% (-0.6 mg/L)
Secondary Benefits
HDL Cholesterol40 mg/dL
+7% (+2.8 mg/dL)
Coronary Atheroma Volume (IVUS)200 mm^3
-7% (-14 mm^3)
Seattle Angina Questionnaire (SAQ) - Physical Limitation Score60/100 points
+13.3% (+8 points)
Common Side Effects
Myalgia (muscle pain)
+8%
Elevated liver enzymes
+2%
New-onset diabetes
+0.5%

Clinical Trial Phases:

Phase 4
3
Aspirin (Low-dose)
80% Effectiveness• 98% Confidence• 80% Safety• 66 trials• 300K participants
HIGH EvidenceExcellent ValueDose: 75-100mg daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

immediate antiplatelet effect, clinical benefit over months-years

Duration

lifetime

Response Rate

15%

Remission Rate

%

Number Needed to Treat (NNT)

80

Number Needed to Harm (NNH)

300

Common Side Effects:

Gastrointestinal bleeding: 1.5%
Dyspepsia: 5%
Hemorrhagic stroke: 0.05%

Annual Cost of Care

Drug Cost

$15

Monitoring

$20

Side Effects

$30

Total Annual

$65

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$500/QALY

Cost per Responder

$433

Treatment Outcomes
Primary Outcomes
Risk of Non-fatal Myocardial InfarctionAnnual incidence: 3.5%
-30% (-1.05 percentage points in annual incidence)
Risk of Non-fatal Ischemic StrokeAnnual incidence: 1.5%
-25% (-0.38 percentage points in annual incidence)
Risk of Major Adverse Cardiovascular Events (MACE)Annual incidence: 6.5%
-22% (-1.43 percentage points in annual incidence)
Secondary Benefits
Risk of Unstable Angina Requiring HospitalizationAnnual incidence: 2.0%
-18% (-0.36 percentage points in annual incidence)
Risk of Coronary RevascularizationAnnual incidence: 4.0%
-15% (-0.60 percentage points in annual incidence)
Quality of Life (EQ-5D VAS score)EQ-5D VAS score: 70/100
+3% (+2.1 points on EQ-5D VAS score)
Common Side Effects
Gastrointestinal bleeding
+1.5%
Dyspepsia
+5%
Hemorrhagic stroke
+0.05%

Clinical Trial Phases:

Phase 4
4
ACE Inhibitors / ARBs (e.g., Lisinopril)
80% Effectiveness• 90% Confidence• 70% Safety• 800 trials• 500K participants
HIGH EvidenceExcellent ValueDose: Lisinopril: 5-40mg daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

days-weeks for blood pressure, months-years for cardiovascular protection

Duration

lifetime

Response Rate

20%

Remission Rate

%

Number Needed to Treat (NNT)

40

Number Needed to Harm (NNH)

100

Common Side Effects:

Cough (ACE inhibitors): 8%
Hyperkalemia: 2%
Hypotension: 5%
Angioedema (rare): 0.1%

Annual Cost of Care

Drug Cost

$30

Monitoring

$150

Side Effects

$50

Total Annual

$230

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$10,000/QALY

Cost per Responder

$1,150

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+80%
Response Rate
+20%
Common Side Effects
Cough (ACE inhibitors)
+8%
Hyperkalemia
+2%
Hypotension
+5%

Clinical Trial Phases:

Phase 4
5
PCSK9 Inhibitors (e.g., Evolocumab)
78% Effectiveness• 90% Confidence• 65% Safety• 50 trials• 70K participants
HIGH EvidenceGood ValueDose: Evolocumab: 140mg every 2 weeks or 420mg monthly (subcutaneous)
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

2-4 weeks for LDL-C reduction, 6-12 months for cardiovascular event reduction

Duration

lifetime

Response Rate

15%

Remission Rate

%

Number Needed to Treat (NNT)

70

Common Side Effects:

Injection site reactions: 5%
Nasopharyngitis: 10%
Flu-like symptoms: 3%

Annual Cost of Care

Drug Cost

$5,000

Monitoring

$100

Side Effects

$20

Total Annual

$5,120

Cost-Effectiveness

GOOD

QALYs Gained

0.2

ICER

$80,000/QALY

Cost per Responder

$34,133

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+78%
Response Rate
+15%
Common Side Effects
Injection site reactions
+5%
Nasopharyngitis
+10%
Flu-like symptoms
+3%

Clinical Trial Phases:

Phase 4
6
Beta-blockers (e.g., Metoprolol)
75% Effectiveness• 90% Confidence• 70% Safety• 600 trials• 400K participants
HIGH EvidenceExcellent ValueDose: Metoprolol succinate ER: 25-200mg daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

immediate for heart rate/BP, months for cardiovascular protection

Duration

lifetime

Response Rate

10%

Remission Rate

%

Number Needed to Treat (NNT)

50

Number Needed to Harm (NNH)

500

Common Side Effects:

Bradycardia: 10%
Fatigue: 15%
Dizziness: 8%
Sexual dysfunction: 7%

Annual Cost of Care

Drug Cost

$40

Monitoring

$75

Side Effects

$30

Total Annual

$145

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.15

ICER

$12,000/QALY

Cost per Responder

$1,450

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+75%
Response Rate
+10%
Common Side Effects
Bradycardia
+10%
Fatigue
+15%
Dizziness
+8%

Clinical Trial Phases:

Phase 4