2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes

Abstract

Disclaimer. The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge, and the evidence available at the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy, and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic, or therapeutic medical strategies; however, the ESC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and, where appropriate and/or necessary, the patient's caregiver. Nor do the ESC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

Plasma circular RNA hsa_circ_0001445 and coronary artery disease: Performance as a biomarker

“…The comparison of biomarker performance with clinical variables and established measurements is also fundamental to obtaining robust evidence for the clinical applicability of hsa_circ_0001445. In addition, CTA is a well‐established technique proposed by clinical guidelines to determine the presence of coronary atherosclerotic burden in patients with stable CAD . Some limitations merit consideration.…”

“…At present, there is no generally accepted or used circulating biomarker for the detection of the disease. Indeed, biomarker‐driven diagnostic strategies are currently not recommended by the recent guidelines on chronic coronary syndromes due to the lack of robust evidence …”

Platelet function testing guided antiplatelet therapy reduces cardiovascular events in Chinese patients with ST‐segment elevation myocardial infarction undergoing percutaneous coronary intervention: The PATROL study

“…DAPT with aspirin (100 mg daily) and a P2Y12 antagonist (clopidogrel 75 mg daily or ticagrelor 90 mg twice a day) was continued for at least 1 year. Additional secondary prevention medications were prescribed for all patients according to the guideline recommendations …”

Long‐term follow‐up of patients undergoing standardized bicycle exercise stress testing: new recommendations for grading of exercise capacity are clinically relevant

“…Among older patients, the proportion of patients being classified as having reduced exercise capacity was 3 or 5 times larger (Lindow et al, 2018). This is emphasized in recent guidelines from the European Society of Cardiology, where exercise ECG is no longer the initial test to be used to establish a diagnosis of stable coronary artery disease (Knuuti et al, 2019). In recent years, other diagnostic modalities have been suggested to be preferred over either treadmill or bicycle exercise stress testing in patients with suspected angina pectoris, since the diagnostic accuracy has been reported to be low (Moss et al, 2017;Knuuti et al, 2018).…”

“…Although more patients are now classified as having reduced exercise capacity, compared with the previous reference values, the present findings support that this grading is highly clinically relevant. However, the prognostic value of exercise stress testing is yet recognized in these guidelines, and exercise stress testing has received a class I recommendation for assessment of exercise tolerance and event risk, as well as evaluation of symptoms and arrhythmia, in selected patients (Knuuti et al, 2019). This is emphasized in recent guidelines from the European Society of Cardiology, where exercise ECG is no longer the initial test to be used to establish a diagnosis of stable coronary artery disease (Knuuti et al, 2019).…”