Evaluation and Management of Patients With Stable Angina: Beyond the Ischemia Paradigm: JACC State-of-the-Art Review

Richard Ferraro, Jacqueline M. Latina, Abdulhamied Alfaddagh, Erin D. Michos, Michael J. Blaha, Steven R. Jones, Garima Sharma, Jeffrey C. Trost, William E. Boden, William S. Weintraub, João A.C. Lima, Roger S. Blumenthal, Valentin Fuster, Armin Arbab-Zadeh

Research output: Contribution to journalReview articlepeer-review

Abstract

Coronary heart disease is a chronic, systemic disease with a wide range of associated symptoms, clinical outcomes, and health care expenditure. Adverse events from coronary heart disease can be mitigated or avoided with lifestyle and risk factor modifications, and medical therapy. These measures are effective in slowing the progression of atherosclerotic disease and in reducing the risk of thrombosis in the setting of plaque disruptions. With increasing effectiveness of prevention and medical therapy, the role of coronary artery revascularization has decreased and is largely confined to subgroups of patients with unacceptable angina, severe left ventricular systolic dysfunction, or high-risk coronary anatomy. There is a compelling need to allocate resources appropriately to improve prevention. Herein, we review the scientific evidence in support of medical therapy and revascularization for the management of patients with stable coronary heart disease and discuss implications for the evaluation of patients with stable angina and public policy.

Original languageEnglish (US)
Pages (from-to)2252-2266
Number of pages15
JournalJournal of the American College of Cardiology
Volume76
Issue number19
DOIs
StatePublished - Nov 10 2020

Keywords

  • atherosclerosis
  • coronary artery disease
  • coronary heart disease
  • ischemic syndrome
  • stable ischemic heart disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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