[Strategy for Chronic Coronary Syndrome - PCI or optimal medical therapy]

Area of Science:

• Cardiology
• Clinical Medicine

Background:

• The European Society of Cardiology (ESC) updated terminology from "stable coronary artery disease (CAD)" to "chronic coronary syndrome (CCS)" to emphasize its progressive nature.
• Optimal medical therapy and myocardial revascularization are key in CCS management, but patient selection for percutaneous coronary intervention (PCI) remains challenging.

Purpose of the Study:

• To review diagnostic and therapeutic strategies for chronic coronary syndrome (CCS) patients.
• To clarify the role of percutaneous coronary intervention (PCI) in CCS management.
• To outline an optimal treatment strategy based on current ESC guidelines and the ISCHEMIA Trial.

Main Methods:

• Review of current European Society of Cardiology (ESC) guidelines for chronic coronary syndrome (CCS).
• Analysis of findings from the ISCHEMIA Trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches).
• Discussion of diagnostic and therapeutic approaches for CCS patients.

Main Results:

• The heterogeneity of CCS presents challenges in identifying patients who benefit from PCI.
• The optimal role of PCI in CCS patients is still debated.
• Current guidelines and trials offer insights into personalized treatment strategies.

Conclusions:

• A tailored approach is necessary for managing chronic coronary syndrome (CCS).
• Percutaneous coronary intervention (PCI) may benefit selected CCS patients, but optimal medical therapy remains foundational.
• Further research and guideline adherence are crucial for improving CCS patient outcomes.