Pocket Guidelines on Chronic Coronary Syndromes

Order Pocket Guidelines

Table of Contents

1. Introduction

2. Stepwise approach to the management of patients with suspected CCS.

2.1. STEP 1: General clinical examination.

2.1.1. History, differential diagnosis, and physical examination.

2.1.2. Basic testing: 12-lead electrocardiogram and biochemistry.

2.2. STEP 2: Further evaluation.

2.2.1. Pre-test clinical likelihood of obstructive atherosclerotic coronary artery disease.

2.2.2. Transthoracic echocardiography at rest.

2.2.3. Exercise ECG testing.

2.2.4. Chest X-ray.

2.2.5. Ambulatory ECG monitoring.

2.3. STEP 3: Confirming the diagnosis.

2.3.1. Anatomical imaging: Coronary computed tomography angiography (CCTA).

2.3.2. Functional imaging.

2.3.3. Invasive tests.

2.3.4. Diagnostic algorithm and selection of appropriate tests.

2.3.5. Adverse event risk assessment.

2.4. STEP 4: Initial therapy.

3. Guideline-directed therapy.

3.1. Patient education, lifestyle optimization for risk factor control,

and exercise therapy.

3.2. Antianginal/anti-ischaemic medication.

3.2.1. General strategy.

3.2.2. Beta-blockers.

3.2.3. Combination therapy.

3.3. Medical therapy for event prevention.

3.3.1. Antithrombotic drugs.

3.3.2. Lipid-lowering drugs.

3.3.3. Sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists.

3.3.4. Anti-inflammatory agents for event prevention.

3.4. Revascularization for chronic coronary syndromes.

3.4.1. Revascularization indications and modalities.

3.4.2. Patient–physician shared decision-making to perform and select revascularization modality.

3.4.3. Institutional protocols, clinical pathways, and quality of care.

4. Optimal assessment and treatment of specific groups.

4.1. Heart failure.

4.2. Angina/ischaemia with non-obstructive coronary arteries (ANOCA/INOCA).

4.2.1. Definition.

4.2.2. Diagnosis.

4.2.3. Management of angina/ischaemia with non-obstructive coronary arteries (ANOCA/INOCA).

4.3. Other specific patient groups.

4.4. Screening for coronary artery disease in asymptomatic individuals.

5. Long-term follow-up and adherence.

5.1. Adherence and persistence.

5.1.1. Adherence to healthy lifestyle behaviours.

5.1.2. Adherence to medical therapy.

5.2. Diagnosis of disease progression.

5.3. Treatment of myocardial revascularization failure.

5.4. Recurrent or refractory angina/ischaemia.