Stable angina pectoris.
The stable coronary artery disease (SCAD) population is a heterogeneous group of patients both for clinical presentations and for different underlying mechanisms. The recent European Society of Cardiology guidelines extensively review SCAD from its definition to patients' diagnostic and therapeutic management. In this review, we deal with five topics that, in our opinion, represent the most intriguing, novel and/or clinically relevant aspects of this complex coronary condition. Firstly, we deal with a peculiar SCAD population: patients with angina and 'normal' coronary arteries. Secondly, we reinforce the clinical importance of a diagnostic approach based on the pretest probability of disease. Thirdly, we review and critically discuss the novel pharmacological therapies for SCAD patients. Finally, we analyse the results of the most recent clinical trials comparing revascularization versus optimal medical therapy in SCAD patients and review the currently recommended use of intracoronary functional evaluation of stenosis.
Thoraxcenter, BA 587, Erasmus MC, Rotterdam, The Netherlands, m.valgimigli@erasmusmc.nl.
Marco
M
Valgimigli
Simone
S
Biscaglia
D000083:Acetanilides / Q000627:therapeutic use; D060050:Angina, Stable / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001552:Benzazepines / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D003329:Coronary Vasospasm / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D025401:Echocardiography, Stress; D005080:Exercise Test; D006801:Humans; D000077550:Ivabradine; D055806:Microvessels; D020108:Nicorandil / Q000627:therapeutic use; D009566:Nitrates / Q000627:therapeutic use; D062645:Percutaneous Coronary Intervention; D010879:Piperazines / Q000627:therapeutic use; D000069458:Ranolazine; D016540:Smoking Cessation; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000083:Acetanilides; D001552:Benzazepines; D009566:Nitrates; D010879:Piperazines; D014665:Vasodilator Agents; D020108:Nicorandil; D000077550:Ivabradine; D000069458:Ranolazine