Contemporary management of stable coronary Artery disease - Implications of the ISCHEMIA trial

Shun Kohsaka, Kenji Fukushima, Ippei Watanabe, Susumu Manabe, Nozomi Niimi, Yodo Gatate, Mitsuaki Sawano, Shintaro Nakano

Research output: Contribution to journalReview articlepeer-review

Abstract

Coronary artery disease (CAD) remains a leading cause of mortality and morbidity in developed countries. Although urgent revascularization is the cornerstone of management of acute coronary syndrome (ACS), for patients with stable CAD recent large-scale clinical trials indicate that a mechanical 'fix' of a narrowed artery is not obviously beneficial; ACS and stable CAD are increasingly recognized as different clinical entities. We review the perspectives on (1) modifying the diagnostic pathway of stable CAD with the incorporation of modern estimates of pretest probability, (2) non-imaging evaluations based on their availability, (3) the optimal timing of invasive coronary angiography and revascularization, and (4) the implementation of medical therapy during the work-up.

Original languageEnglish
Pages (from-to)1919-1927
Number of pages9
JournalCirculation Journal
Volume85
Issue number11
DOIs
Publication statusPublished - 2021

Keywords

  • Acute coronary syndrome
  • Coronary artery disease
  • Diagnostics
  • Ischemia
  • Management

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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