p.5 抽出テキスト

coronary angiography to guide revascularization (see also Evidence Table 12) ................................................................................................................... 3447 Recommendation Table 13 — Recommendations for selection of initial diagnostic tests in individuals with suspected chronic coronary syndrome (see also Evidence Table 13) ...................................................... 3453 Recommendation Table 14 — Recommendations for definition of high risk of adverse events (see also Evidence Table 14) .................... 3454 Recommendation Table 15 — Recommendations for cardiovascular risk reduction, lifestyle changes, and exercise interventions in patients with established chronic coronary syndrome (see also Evidence Table 15) ............................................................................................... 3457 Recommendation Table 16 — Recommendations for antianginal drugs in patients with chronic coronary syndrome (see also Evidence Table 16) ................................................................................................................... 3459 Recommendation Table 17 — Recommendations for antithrombotic therapy in patients with chronic coronary syndrome (see also Evidence Table 17) ............................................................................ 3465 Recommendation Table 18 — Recommendations for lipid-lowering drugs in patients with chronic coronary syndrome (see also Evidence Table 18) ................................................................................................................... 3467 Recommendation Table 19 — Recommendations for sodium– glucose cotransporter 2 inhibitors and/or glucagon-like peptide-1 receptor agonists in patients with chronic coronary syndrome (see also Evidence Table 19) ...................................................................................... 3468 Recommendation Table 20 — Recommendations for anti-inflammatory drugs in patients with chronic coronary syndrome (see also Evidence Table 20) ............................................................................ 3469 Recommendation Table 21 — Recommendations for angiotensin-converting enzyme inhibitors in patients with chronic coronary syndrome (see also Evidence Table 21) ................................. 3469 Recommendation Table 22 — Recommendations for revascularization in patients with chronic coronary syndrome (see also Evidence Table 22) ...................................................................................... 3476 Recommendation Table 23 — Recommendations for mode of revascularization in patients with chronic coronary syndrome (see also Evidence Table 23) ...................................................................................... 3477 Recommendation Table 24 — Recommendations for management of chronic coronary syndrome patients with chronic heart failure (see also Evidence Table 24) ............................................................................ 3478 Recommendation Table 25 — Recommendations for diagnosis and management of patients with angina/ischaemia with non-obstructive coronary arteries (see also Evidence Table 25) ........................................ 3485 Recommendation Table 26 — Recommendations for older, female, high bleeding risk, comorbid, and socially/geographically diverse patients (see also Evidence Table 26) ........................................................... 3488 Recommendation Table 27 — Recommendations for screening for coronary artery disease in asymptomatic individuals (see also Evidence Table 27) ............................................................................................... 3488 Recommendation Table 28 — Recommendations for adherence to medical therapy and lifestyle changes (see also Evidence Table 28) 3492 Recommendation Table 29 — Recommendations for diagnosis of disease progression in patients with established chronic coronary syndrome (see also Evidence Table 29) ...................................................... 3495 Recommendation Table 30 — Recommendations for treatment of revascularization failure (see also Evidence Table 30) .......................... 3496 Recommendation Table 31 — Recommendations for recurrent or refractory angina/ischaemia (see also Evidence Table 31) .................. 3496

List of tables

Table 1 Classes of recommendations .......................................................... 3422 Table 2 Levels of evidence ................................................................................ 3423 Table 3 New major recommendations in 2024 ...................................... 3426 Table 4 Revised recommendations ............................................................... 3430 Table 5 Grading of effort angina severity according to the Canadian Cardiovascular Society ........................................................................................ 3436 Table 6 Overview of non-invasive tests used for first-line testing in individuals with suspected chronic coronary syndrome ...................... 3451 Table 7 Practical advice on lifestyle counselling and interventions . 3455 Table 8 Options for extended intensified antithrombotic therapy 3464 Table 9 Summary of trial-based evidence for the comparison of percutaneous coronary intervention and coronary artery bypass grafting in patients with left main coronary artery disease ................ 3473 Table 10 ‘What to do’ and ‘What not to do’ .......................................... 3499 List of figures

Figure 1 (Central Illustration) Clinical presentations of chronic coronary syndrome and mechanisms of myocardial ischaemia ........ 3425 Figure 2 Stepwise approach to the initial management of individuals with suspected chronic coronary syndrome ............................................ 3434 Figure 3 Main CCS symptoms: angina and exertional dyspnoea ..... 3435 Figure 4 Estimation of the clinical likelihood of obstructive coronary artery disease .......................................................................................................... 3439 Figure 5 Adjustment and reclassification of the estimated clinical likelihood of obstructive coronary artery disease .................................. 3448 Figure 6 Appropriate first-line testing in symptomatic individuals with suspected chronic coronary syndrome ............................................ 3449 Figure 7 Initial management of symptomatic individuals with suspected chronic coronary syndrome ....................................................... 3450 Figure 8 Ruling in and ruling out functionally significant obstructive coronary artery disease by sequential anatomical (coronary computed tomography angiography) and functional (dobutamine stress echocardiography) testing.a ................................................................. 3452 Figure 9 Possible combinations of antianginal drugs .............................. 3458 Figure 10 Antithrombotic drugs for chronic coronary syndromes: pharmacological targets ...................................................................................... 3461 Figure 11 Antithrombotic treatment in chronic coronary syndrome patients undergoing percutaneous coronary intervention ................. 3463 Figure 12 Prevalence of disease characteristics in patients with ANOCA/INOCA referred for invasive coronary functional testing 3480 Figure 13 Diagnostic algorithm for patients with angina/ischaemia with non-obstructive coronary arteries ...................................................... 3482 Figure 14 Spasm provocation and functional testing protocol ......... 3483 Figure 15 Treatment of angina/ischaemia with non-obstructive coronary arteries .................................................................................................. 3484 Figure 16 Actions on the five dimensions of adherence to therapy 3490 Figure 17 Strategies for long-term adherence to a healthy lifestyle 3491 Figure 18 Approach for the follow-up of patients with established chronic coronary syndrome ............................................................................. 3494

Abbreviations and acronyms

99mTc Technetium-99m ACE-I Angiotensin-converting enzyme inhibitor Ach Acetylcholine ACS Acute coronary syndrome(s) AF Atrial fibrillation AKI Acute kidney injury ALPHEUS Assessment of Loading with the P2Y12 Inhibitor Ticagrelor or Clopidogrel to Halt Ischemic Events in Patients Undergoing Elective Coronary Stenting ANOCA Angina with non-obstructive coronary arteries ARB Angiotensin receptor blocker

ESC Guidelines                                                                                                                                                                                          3419

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