Consensus statement on evolving terminology in angina and its impact on Indian clinical practice

Abstract

Coronary artery disease (CAD) is one of the major cardiovascular diseases affecting the global human population. Patients with known cardiovascular disease who have not had a recent acute event are often referred to as having stable coronary artery disease (CAD). However, the concept of ‘stable’ CAD is misleading due to the continuing risks of cardiovascular events over the long term. The recent 2019 European Society of Cardiology guidelines have changed the clinical terminology of ‘stable’ CAD to ‘chronic coronary syndrome’ (CCS). Apart from terminology, the guidelines provided new recommendations on how to manage continuing risk of ischemic events. An eminent group of consulting physicians and cardiologists from India collaborated in order to discuss and understand evolving terminologies in angina and their impact on Indian clinical practice. Extensive literature review, discussions, and feedback from the cardiologists led to the development of a consensus statement for Indian clinical practice. The terminology of CCS was found to be more apt for the Indian context. A careful history and clinical examination followed by investigations can ensure early and accurate diagnosis of CCS. The management of CCS should include combination of medical therapy and revascularization based on the need, severity of disease, and patient acceptability.