Chronic Coronary Artery Disease

Abstract

Over the last two decades, due to improvement in the management of acute coronary syndromes (ACS), the increasing aging of the population, and the epidemics of diabetes and obesity, the management of patients with chronic coronary artery disease (CAD) has become an increasingly common and important part of clinical practice. The spectrum of chronic ischemic heart disease includes patients who have asymptomatic myocardial ischemia, stable angina pectoris, unstable angina, or prior myocardial infarction (MI) with residual ischemia. Mortality from ischemic heart disease increases in all age groups as blood pressure, vascular stiffness and endothelial dysfunction become more prevalent. New insights into the mechanisms underlying chronic stable coronary disease have led to the emergence of new anti-ischemic treatments and the role for revascularization has been reformulated.