Coronary heart disease (CHD), which usually presents as a heart attack (or myocardial infarction, MI) is the most common cause of death and disability both in the UK and globally. The way in which CHD is treated and prevented therefore has huge implications for patients, health professionals and policymakers. Once a person has a heart attack, prevention of further heart attacks, stroke or death, or secondary prevention, is crucial. There is strong evidence for benefit of several drugs and treatments after heart attacks to this end, including aspirin, statins, ACE inhibitors and beta-blockers.

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Myocardial infarction (MI) results from a blockage in one or more of the coronary arteries and represents the largest single cause of death worldwide [1]. Even before the introduction of coronary-artery bypass grafting (CABG) in 1968, the focus of treatment and research was opening the blocked artery. Percutaneous coronary intervention (PCI) was first used in 1977, and includes angioplasty, bare-metal stents and more recently, drug-eluting stents (DES). Heart surgeons and cardiologists have argued for the last 30 years over the best way to open up coronary arteries.

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