Controversy exists regarding how to best manage chronic stable angina. Intuitively, it seems that because it is usually caused by coronary artery lesions, addressing those lesions either via percutaneous coronary angiography or coronary artery bypass operations would be the best way to manage this problem. Several studies have suggested that this is not the case and that results of these interventions are no better than optimal medical management. Recently, a very large trial examining this clinical question has provided results suggesting that any approach works about the same. We interviewed Donald Lloyd-Jones, MD, chair of the department of preventive medicine at Northwestern University, during the recent American Heart Association meeting about this issue. Related articles: Baseline Characteristics and Risk Profiles of Participants in the ISCHEMIA Randomized Clinical Trial Does This Patient With Chest Pain Have Acute Coronary Syndrome?: The Rational Clinical Examination Systematic Review Coronary Microvascular Dysfunction Causing Cardiac Ischemia in Women Acupuncture as Adjunctive Therapy for Chronic Stable Angina: A Randomized Clinical Trial