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

Coronary artery disease (CAD) is a pathologic process characterized by atherosclerotic plaque accumulation, in the epicardial arteries, whether obstructive or non-obstructive. This process may be modified by lifestyle adjustments, pharmacological therapies and invasive interventions designed to achieve disease stabilization or regression. The disease can have long stable periods but can also become unstable at any time, typically due to an acute atherothrombotic event caused by plaque rupture or erosion. However, the disease is chronic, most often progressive, and hence serious even in clinically apparently silent periods. The dynamic nature of the CAD process results in various clinical presentations which may be conveniently categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). The guidelines presented here refer to the management of patients with CCS.