European Society of Cardiology Guidelines on the Management of Stable Coronary Artery Disease (2013)

Abstract

Introduction. In 2013 the updated guidelines of the European Society of Cardiology for the treatment of stable ischemic (coronary) heart disease were published. The new document, in comparison with the same recommendations of 2006, introduced a number of significant changes that require some clarification. Aim. To consider the Recommendations of the European Cardiology Association for the management of patients with stable coronary heart disease (2013) to assist the physicians in selecting the best treatment option for the individual patient in daily practice. Materials and methods. Recommendations for application, interaction and side effects of the main drugs are considered, evaluation of possible complications in patients with ischemic (coronary) heart disease in accordance with the Recommendations of the European Association of Cardiologists regarding the management of patients with stable coronary heart disease (2013) has been made. Results. In the accordance with the recommendations, instead of the term “stable angina pectoris”, a more precise term – “stable coronary artery disease” – was used to determine the nosology. In addition, the new recommendations contain a number of changes: – in the diagnostic algorithm of the chronic heart disease more attention is paid to determining the pretest probability of the disease; – the use of up-to-date information on pretest probability will help to reduce the incidence of undesirable chronic heart disease, especially in women; – in the diagnosis of coronary artery disease, the role of visualization techniques, such as resonance imaging (MRI), computed tomography (CT), angiography, is increasing; – considerable attention is focused on the study of coronary vasospasm and microvascular dysfunction, as the most common causes of angina pectoris; – more attention is paid to combating risk factors, and therefore, prevention of serious coronary complications; – updated recommendations for the use of anti-anginal drugs are presented; – new methods of the evaluation of ischemia and damage to coronary arteries, as well as technical devices for the myocardial revascularization, are recommended; – an emphasis on the strategy of treatment: revascularization in comparison with medical treatment, as well as the choice of the method of revascularization, as necessary was made. Conclusions. The updated recommendations have the renewed information about the pathogenesis, diagnosis and treatment of stable coronary artery disease will assist the physicians in selecting the best treatment option for the individual patient in daily practice.

Keywords

• diagnosis
• ischemic (coronary) heart disease
• patogenesis
• treatment