Coronary artery disease is extremely common among elderly people and accounts for half of all deaths in those who are more than 65 years old. Although the condition is essentially the same as that encountered in younger patients, the management of coronary artery disease in elderly subjects can be difficult because the anticipated benefits and risks of the various treatment options are often altered by the presence of co-morbid conditions. Moreover, the results of the major outcome studies that underpin most treatment guidelines may not be relevant to the needs of many elderly patients for several reasons.