Key result
Review outlines a practical framework for stable angina integrating tailored medical therapy, lifestyle, and revascularization.
Why the study?
Angina remains underdiagnosed and undertreated in patients with CCS, and extensive contemporary guidelines may hinder uptake by non-specialists.
Translates extensive contemporary guidelines into a simplified, accessible framework to help practicing physicians improve diagnosis rates and optimize evidence-based management of stable angina.
May support guideline-directed stable angina care; leaves open whether the framework improves outcomes.
Longer life expectancy and advancements in coronary artery disease management have improved life expectancy and survival, increasing the prevalence of chronic coronary syndromes (CCS). Angina is a common symptom in patients with CCS but remains underdiagnosed and undertreated. Contemporary guidelines provide detailed information on diagnosing and treating angina based on evidence and expert consensus; however, their extensive nature may hinder uptake by non-specialists. This review presents a practical approach to diagnosing stable angina, followed by the three pillars of CCS management: 1) healthy lifestyle including appropriate exercise, diet, and avoiding toxic habits; 2) optimal medical therapy, including treatment recommended to prevent cardiovascular events and drugs for the control of myocardial ischemia and angina tailored to the patient's comorbidities; and 3) myocardial revascularization when indicated. This approach may be useful for practicing physicians but is not intended to substitute more detailed and authoritative documents. Checklists are proposed to help focus patient-physician interactions and make follow-up visits more efficient. This approach seeks to increase the proportion of correct angina diagnoses and patients receiving evidence-based treatments, emphasizing the importance of patient education, managing residual angina, and reducing cardiovascular risk. We include reference to the recently published 2024 ESC guidelines on chronic coronary syndromes.
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Manolis et al. (2025) conducted a review in Stable angina / Chronic coronary syndromes. Contemporary diagnostic and management approach was evaluated. This review outlines a practical framework for practicing physicians to diagnose and treat stable angina, focusing on lifestyle modifications, tailored optimal medical therapy, and appropriate revascularization.
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