Innovations in Diagnosis and Treatment of Coronary Artery Disease

Background: Coronary artery disease (CAD) remains a significant health challenge, placing a heavy burden on people and healthcare systems worldwide. Objectives: This narrative review aims to provide a comprehensive overview of recent advancements in the diagnosis, intervention, and pharmacological management of CAD, with a focus on emerging technologies shaping its future. Methods: This is a narrative review that synthesises information from diverse sources, including clinical trials, systematic reviews, meta-analyses, and preclinical studies, to provide a comprehensive overview of the current landscape and emerging trends in CAD management. The literature included in this review was sourced from original research articles and review papers published between January 2010 and December 2025. Results: Early detection has been transformed by non-invasive imaging, such as PCAT, and the addition of invasive and non-invasive FFR technology enables quicker and more accurate diagnoses. Biomarkers, such as high-sensitivity troponin, have further improved the precision of acute coronary syndrome detection, enhancing early intervention. In interventional cardiology, new-generation drug-eluting stents (DESs) have lowered restenosis rates, whereas robotic-assisted percutaneous coronary intervention (PCI) offers precision and reduced operator radiation exposure. Furthermore, the efficacy of drug-coated balloons (DCBs) has been established in the management of in-stent restenosis, and their application in de novo coronary lesions and bifurcation anatomy remains promising. Looking ahead, nanomedicine promises targeted plaque reduction and vascular repair, while 3D-bioprinted blood vessels offer durable, biocompatible grafts for surgical applications. Pharmacological developments, including modern cholesterol-lowering drugs, have also been crucial in achieving cholesterol targets. Conclusions: Despite significant advancements in diagnosis, intervention, and pharmacotherapy, several critical challenges remain, including the need for validated biomarkers and imaging modalities to identify vulnerable atheroma before symptoms arise. Continued research is essential to improve patient outcomes and address the global burden of CAD.