Management of Residual Risk in Chronic Coronary Syndromes. Clinical Pathways for a Quality-Based Secondary Prevention

Area of Science:

• Cardiology
• Internal Medicine

Background:

• Chronic coronary syndrome (CCS), a major cause of global morbidity and mortality, is characterized by persistent cardiovascular risk despite treatment.
• The term 'stable' is replaced by 'chronic' to reflect the dynamic nature of coronary artery disease (CAD).
• Patients with CCS face residual cardiovascular risk, contributing to major adverse cardiovascular events (MACE).

Purpose of the Study:

• To review diagnostic and therapeutic challenges in CCS management.
• To highlight the importance of identifying residual cardiovascular risk pathways.
• To advocate for enhanced multidisciplinary care models in CCS.

Main Methods:

• This review synthesizes current literature on CCS management.
• It examines pathogenetic pathways contributing to residual risk.
• It discusses diagnostic and therapeutic strategies.

Main Results:

• Residual cardiovascular risk in CCS stems from thrombotic, inflammatory, metabolic, and procedural pathways.
• Identifying individual risk profiles is crucial for tailored interventions.
• Newer management strategies and healthcare models show prognostic benefits.

Conclusions:

• Effective CCS management necessitates a focus on residual cardiovascular risk.
• Multidisciplinary approaches and personalized treatment strategies are essential.
• Further research into novel preventive treatments targeting specific pathways is warranted.