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Introduction Coronary heart disease is a common killer and accounts for approximately 105,000 deaths per year in the UK. Recent research has shown that the most effective strategy, despite the advances in interventional cardiology, is effective secondary prevention and risk factor modification along with a robust rehabilitation programme to improve lifestyle, especially for those who have experienced a coronary event.2 It is also the most cost-effective way of reducing cardiovascular mortality and morbidity. Salvaging the acutely ischaemic myocardium with catheter-based interventions without addressing the underlying pathophysiological proces