[Strategy for Chronic Coronary Syndrome - PCI or optimal medical therapy].

Strategy for Chronic Coronary Syndrome - PCI or optimal medical therapy In the new guidelines of the European Society of Cardiology (ESC), the previous term "stable coronary artery disease (CAD)" was replaced by a new term "chronic coronary syndrome (CCS)" in order to highlight the chronic but also progressive pathological character of CAD. Both optimal medical therapy and myocardial revascularization play a central role in the treatment of patients with CCS. However, due to the heterogeneity of CCS, it is a challenge to determine in clinical practice which patients may benefit from percutaneous coronary intervention (PCI). In addition, the importance of PCI is still controversial, especially in patients with CCS. Hence, this review discusses diagnostic and therapeutic approaches in patients with CCS considering the current ESC-guidelines and the ISCHEMIA Trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) in order to outline the optimal strategy for improving symptoms and prognosis.