2024 ESC Guidelines for the Management of Chronic Coronary Syndromes

The updated guidelines for managing chronic coronary symptoms (CCS) provide a framework for diagnosing and treating suspected and confirmed cases of CCS. They emphasize using a risk factor-weighted model to better estimate the likelihood of obstructive coronary artery disease (CAD), which improves upon the previous 2019 ESC model by more accurately classifying patients into low-risk categories where further testing might not be needed. The guidelines include a new diagnostic algorithm for moderate or high-risk patients and expand on the diagnosis and treatment of angina with no or nonobstructive CAD (ANOCA-INOCA). They offer detailed recommendations for anti-anginal medications, therapies to prevent events, adherence strategies and the selection of revascularization techniques based on recent research. The guidelines also address management strategies for recurrent or refractory angina and ischemia.