[Chronic coronary syndrome]

Area of Science:

• Cardiology
• Cardiovascular Medicine

Background:

• The term "stable coronary artery disease" has been updated to "chronic coronary syndrome" (CCS) in the 2019 European Society of Cardiology guidelines.
• Significant shifts in diagnostic, therapeutic, and preventive strategies for CCS are highlighted.

Purpose of the Study:

• To summarize the key changes in the diagnosis, treatment, and prevention of chronic coronary syndrome (CCS) as per the 2019 ESC guidelines.
• To underscore the evolving role of non-invasive imaging and individualized antithrombotic therapy in CCS management.

Main Methods:

• Review of the 2019 European Society of Cardiology guidelines concerning chronic coronary syndrome.
• Analysis of diagnostic advancements, focusing on non-invasive imaging modalities.
• Evaluation of current antithrombotic treatment strategies based on thrombosis and bleeding risks.

Main Results:

• Increased emphasis on non-invasive diagnostic tools, notably coronary CT angiography, for CCS evaluation.
• Antithrombotic treatment selection and duration should be personalized, considering individual thrombosis and bleeding risks.
• These principles are particularly crucial in patients who have undergone coronary revascularization.

Conclusions:

• The updated guidelines for chronic coronary syndrome necessitate a paradigm shift towards personalized, risk-stratified management.
• Non-invasive imaging and tailored antithrombotic therapy are central to optimizing outcomes in CCS patients.