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For a long time, most doctors and patients believed that heart disease was a one-way street. Once your arteries started to clog up with  plaque , the goal was simply to slow down the decline. We treated it like a rust problem on an old car—you can’t really get rid of the rust; you just try to paint over it or keep it from spreading too fast. It felt like an unstoppable force of aging.But what if heart disease wasn’t a life sentence? Imagine your arteries are like a  garden hose .
Introduction: Challenging the Paradigm of Permanent Progression The management of coronary artery disease (CAD) has traditionally been viewed through the lens of “risk management.” In this paradigm, pharmacological interventions such as statins and procedural approaches such as Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Grafting (CABG) are deployed to slow the expected progression of disease. However, these approaches primarily address late-stage manifestations—the “downstream” consequences—rather than the “upstream” cellular and molecular drivers of plaque formation and instability.
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