Chronic Coronary Syndrome Real Practice and Guidelines

Coronary artery disease (CAD) refers to the presence of atherosclerotic plaques in the coronary arteries, Which can be non-obstructive or obstructive. It represents a major cause of morbidity, mortality, Hospitalization and health expenditure.

The most recent European Guidelines for the diagnosis and management of CCS delineate six common CCS scenarios: patients with suspected CAD and stable angina symptoms and/or dyspnea; patients with new onset of heart failure or left ventricular dysfunction and suspected CAD; asymptomatic and symptomatic patients with stabilized symptoms within one year after an acute coronary syndrome, or patients with recent revascularisation; asymptomatic and symptomatic patients beyond one year after initial diagnosis or revascularisation; Patients with angina and suspected vasospastic or microvascular disease; Asymptomatic subjects in whom CAD is detected at screening. Although these scenarios are heterogeneous, they are associated with an increased risk of acute events, and the stability of CCS patients over time depends on prompt diagnosis, optimal treatment and secondary prevention strategies, including Lifestyle modifications, and pharmacotherapy.

Inclusion criteria

Adult patients (18 years or older) with a confirmed or suspected diagnosis of CCS, fall within one of the following broad CCS categories:

• Patients with angina and/or dyspnea, and suspected coronary artery disease.
• Patients with new onset of heart failure or reduced left ventricular function.
• Patients within 1 year after an acute coronary syndrome or recent revascularization.
• Patients beyond 1 year after initial diagnosis or revascularization.
• Patients with ANOCA (e.g., microvascular angina, vasospastic angina).
• Asymptomatic subjects referred for screening for coronary artery disease.

Exclusion criteria

• Patients with a recent acute coronary syndrome (defined as those within 1 month of a diagnosis of unstable angina, non-ST-segment elevation myocardial infarction or ST-segment elevation myocardial infarction)