[Chronic coronary syndrome - new ESC guidelines]

Abstract

The European Society of Cardiology has released new 2024 guidelines on chronic coronary syndrome. These guidelines emphasize that patients with this condition should be actively assessed and treated to reduce the risk of future events. Key updates include the introduction of a risk factor-based clinical probability model to aid in this process. Furthermore, the guidelines stress that coronary CT angiography is recommended as the first-line diagnostic method for patients with a low to moderate probability of coronary artery disease. In cases of moderate to high probability, functional tests such as stress echocardiography, PET-CT, or perfusion MRI are advised, depending on availability. The guidelines recommend that all patients with chronic coronary artery disease receive high-intensity lipid-lowering treatment, with a target LDL level of less than 1.4 mmol/L. For patients with non-obstructive coronary artery disease who continue to experience persistent angina pectoris, further investigation of the microcirculation is recommended.