Stable ischaemic heart disease
Chronic coronary syndromes from pretest likelihood to CT coronary angiography, antianginal choices, event prevention, when revascularisation helps (ISCHEMIA, REVIVED), ANOCA, and IHD in older people.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Chronic coronary syndrome (ESC 2024) covers stable angina, the patient after ACS or revascularisation, ischaemic LV dysfunction and angina with non-obstructive coronary arteries (ANOCA).
- Treatment has two aims that need separate thinking: relieve symptoms (antianginals, sometimes revascularisation) and prevent events (antiplatelet, statin, risk factors).
- In stable patients, revascularisation mostly relieves symptoms. ESC 2024 recommends it for prognosis only in specific anatomy: significant left main stenosis, functionally significant three-vessel or proximal LAD disease, and multivessel disease with LVEF ≤35% suitable for CABG.
Loading the rest of the note…
Finished reading?
Sources
- Vrints C, Andreotti F, Koskinas KC et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024;45:3415-537European Society of Cardiology, 2024
- 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary DiseaseAmerican Heart Association and American College of Cardiology, 2023
- Brieger D, Cullen L, Briffa T et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guideline for diagnosing and managing acute coronary syndromes 2025. Heart Lung Circ 2025;34(4):309-397AU/NZNational Heart Foundation of Australia and CSANZ (Heart, Lung and Circulation), 2025
- Australian guideline for assessing and managing cardiovascular disease riskAU/NZCommonwealth of Australia (Australian Chronic Disease Prevention Alliance), 2023
- Therapeutic Guidelines: Cardiovascular. Stable anginaAU/NZTherapeutic Guidelines Limited (eTG complete), current eTG edition (version not verified)
- Assessing Fitness to Drive for commercial and private vehicle driversAU/NZAustroads and National Transport Commission, 2022 (as amended)
- Maron DJ, Hochman JS, Reynolds HR et al. Initial invasive or conservative strategy for stable coronary disease (ISCHEMIA). N Engl J Med 2020;382:1395-407New England Journal of Medicine, 2020
- Perera D, Clayton T, O'Kane PD et al. Percutaneous revascularization for ischemic left ventricular dysfunction (REVIVED-BCIS2). N Engl J Med 2022;387:1351-60New England Journal of Medicine, 2022
- Farkouh ME, Domanski M, Sleeper LA et al. Strategies for multivessel revascularization in patients with diabetes (FREEDOM). N Engl J Med 2012;367:2375-84New England Journal of Medicine, 2012
- Munkhaugen J, Kristensen AMD, Halvorsen S et al. Beta-blockers after myocardial infarction in patients without heart failure (BETAMI-DANBLOCK). N Engl J Med 2025;393:1901-11New England Journal of Medicine, 2025
- Nidorf SM, Fiolet ATL, Mosterd A et al. Colchicine in patients with chronic coronary disease (LoDoCo2). N Engl J Med 2020;383:1838-47New England Journal of Medicine, 2020
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback