Management of Residual Risk in Chronic Coronary Syndromes. Clinical Pathways for a Quality-Based Secondary Prevention. in Journal of clinical medicine / J Clin Med. 2023 Sep 15;12(18):5989. doi: 10.3390/jcm12185989.

2023
AO Cuneo

Tipo pubblicazione

Review

Autori/Collaboratori (23)Vedi tutti...

Giubilato S
Cardiology Department, Cannizzaro Hospital, 95126 Catania, Italy.
Lucà F
Cardiology Department, Grande Ospedale Metropolitano, AO Bianchi Melacrino Morelli, 89129 Reggio Calabria, Italy.
Abrignani MG
Operative Unit of Cardiology, P. Borsellino Hospital, 91025 Marsala, Italy.

et alii...

Abstract

Chronic coronary syndrome (CCS), which encompasses a broad spectrum of clinical presentations of coronary artery disease (CAD), is the leading cause of morbidity and mortality worldwide. Recent guidelines for the management of CCS emphasize the dynamic nature of the CAD process, replacing the term "stable" with "chronic", as this disease is never truly "stable". Despite significant advances in the treatment of CAD, patients with CCS remain at an elevated risk of major cardiovascular events (MACE) due to the so-called residual cardiovascular risk. Several pathogenetic pathways (thrombotic, inflammatory, metabolic, and procedural) may distinctly contribute to the residual risk in individual patients and represent a potential target for newer preventive treatments. Identifying the level and type of residual cardiovascular risk is essential for selecting the most appropriate diagnostic tests and follow-up procedures. In addition, new management strategies and healthcare models could further support available treatments and lead to important prognostic benefits. This review aims to provide an overview of the diagnostic and therapeutic challenges in the management of patients with CCS and to promote more effective multidisciplinary care.

Accesso banca dati bibliografica

PMID : 37762932

DOI : 10.3390/jcm12185989

Keywords

multidisciplinary management; angina; chronic coronary syndromes; secondary prevention; residual cardiovascular risk; percutaneous coronary intervention; optimal medical therapy;