2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes

Knuuti J, Wijns W, Achenbach S, Agewall S, Barbato E, Bax JJ, Capodanno D, Cuisset T, Deaton C, Dickstein K, Edvardsen T, Escaned J, Funck-Brentano C, Gersh BJ, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Prescott E, Saraste A, Storey RF, Svitil P, Valgimigli M, Windecker S, Aboyans V, Baigent C, Collet JP, Dean V, Delgado V, Fitzsimons D, Gale CP, Grobbee DE, Halvorsen S, Hindricks G, Iung B, Jüni P, Katus HA, Landmesser U, Leclercq C, Lettino M, Lewis BS, Merkely B, Mueller C, Petersen S, Petronio AS, Richter DJ, Roffi M, Shlyakhto E, Simpson IA, Sousa-Uva M, Touyz RM, Benkhedda S, Metzler B, Sujayeva V, Cosyns B, Kusljugic Z, Velchev V, Panayi G, Kala P, Haahr-Pedersen SA, Kabil H, Ainla T, Kaukonen T, Cayla G, Pagava Z, Woehrle J, Kanakakis J, Toth K, Gudnason T, Peace A, Aronson D, Riccio C, Elezi S, Mirrakhimov E, Hansone S, Sarkis A, Babarskiene R, Beissel J, Cassar Maempel AJ, Revenco V, de Grooth GJ, Pejkov H, Juliebø V, Lipiec P, Santos J, Chioncel O, Duplyakov D, Bertelli L, Dikic AD, Studencan M, Bunc M, Alfonso F, Back M, Zellweger M, Addad F, Yildirir A, Sirenko Y, Clapp B (2020)

Publication Type: Journal article, Review article

Publication year: 2020


Book Volume: 41

Pages Range: 407-477

Journal Issue: 3

DOI: 10.1093/eurheartj/ehz425


Coronary artery disease (CAD) is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries, whether obstructive or non-obstructive. This process can be modified by lifestyle adjustments, pharmacological therapies, and invasive interventions designed to achieve disease stabilization or regression. The disease can have long, stable periods but can also become unstable at any time, typically due to an acute atherothrombotic event caused by plaque rupture or erosion. However, the disease is chronic, most often progressive, and hence serious, even in clinically apparently silent periods. The dynamic nature of the CAD process results in various clinical presentations, which can be conveniently categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). The Guidelines presented here refer to the management of patients with CCS. The natural history of CCS is illustrated in Figure 1.

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Involved external institutions

Università degli Studi di Catania IT Italy (IT) Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet NO Norway (NO) Hospital Clínico San Carlos ES Spain (ES) Slovak Medical University (SMU) / Slovenská zdravotnícka univerzita v Bratislave SK Slovakia (SK) Hôpital de la Timone FR France (FR) Assistance Publique-Hôpitaux de Paris (AP-HP) FR France (FR) Università degli Studi di Napoli Federico II IT Italy (IT) University of Galway (NUIG) / Ollscoil na Gaillimhe IE Ireland (IE) Rabin Medical Center / מרכז רפואי רבין‎‎ IL Israel (IL) Österreichische Kardiologische Gesellschaft AT Austria (AT) University of Sheffield GB United Kingdom (GB) Algerian Society of Cardiology DZ Algeria (DZ) Estonian Society of Cardiology EE Estonia (EE) Société Française de Cardiologie FR France (FR) Danish Society of Cardiology / Dansk Cardiologisk Selskab DK Denmark (DK) Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung (DGK) DE Germany (DE) Hellenic Society of Cardiology GR Greece (GR) Hungarian Society of Cardiology / Magyar Kardiológusok Társasága HU Hungary (HU) Georgian Society of Cardiology GE Georgia (GE) Kosovo Society of Cardiology XK Kosovo (XK) Luxembourg Society of Cardiology LU Luxembourg (LU) Kyrgyz Society of Cardiology KG Kyrgyzstan (KG) Latvian Society of Cardiology LV Latvia (LV) Maltese Cardiac Society MT Malta (MT) Lithuanian Society of Cardiology (LSC) / Lietuvos kardiologų draugija (LKD) LT Lithuania (LT) Moldavian Society of Cardiology MD Moldova, Republic of (MD) Lebanese Society of Cardiology LB Lebanon (LB) Netherlands Society of Cardiology NL Netherlands (NL) Romanian Society of Cardiology RO Romania (RO) Sociedad Española de Cardiología ES Spain (ES) Polskie Towarzystwo Kardiologiczne PL Poland (PL) North Macedonian Society of Cardiology MK Republic of North Macedonia (MK) Tunisian Society of Cardiology and Cardiovascular Surgery TN Tunisia (TN) Swedish Society of Cardiology SE Sweden (SE) Schweizerische Gesellschaft für Kardiologie CH Switzerland (CH) Ukrainian Association of Cardiology UA Ukraine (UA) Turkish Society of Cardiology (TSC) / Türk Kardiyoloji Derneği TR Turkey (TR) Università degli Studi di Brescia IT Italy (IT) Leiden University Medical Center NL Netherlands (NL) Belgian Society of Cardiology BE Belgium (BE) Universitätsklinikum des Saarlandes (UKS) DE Germany (DE) Egyptian Society of Cardiology EG Egypt (EG) Norwegian Society of Cardiology NO Norway (NO) Bispebjerg Hospital DK Denmark (DK) Mayo Clinic US United States (USA) (US) Sociedade Portuguesa de Cardiologia PT Portugal (PT) Cardiology Society of Serbia RS Serbia (RS) Slovenian Society of Cardiology SI Slovenia (SI) Université de Bretagne Occidentale FR France (FR) Turku University Hospital / Turun yliopistollinen keskussairaala (TYKS) FI Finland (FI) Finnish Cardiac Society / Suomen Kardiologinen Seura FI Finland (FI) Belorussian Scientific Society of Cardiologists BY Belarus (BY) School of Clinical Medicine GB United Kingdom (GB) Stavanger University Hospital NO Norway (NO) Universität Bern CH Switzerland (CH) Czech Society of Cardiology CZ Czech Republic (CZ) Irish Cardiac Society IE Ireland (IE) Bulgarian Society of Cardiology BG Bulgaria (BG) Russian Society of Cardiology / Российское кардиологическое общество RU Russian Federation (RU) Association of Cardiologists of Bosnia & Herzegovina BA Bosnia And Herzegovina (BA) Italian Federation of Cardiology (FIC) IT Italy (IT) Icelandic Society of Cardiology IS Iceland (IS) Slovak Society of Cardiology SK Slovakia (SK) Cyprus Society of Cardiology CY Cyprus (CY) Israel Heart Society IL Israel (IL) San Marino Society of Cardiology SM San Marino (SM) Universitat de Barcelona (UB) / University of Barcelona ES Spain (ES)

How to cite


Knuuti, J., Wijns, W., Achenbach, S., Agewall, S., Barbato, E., Bax, J.J.,... Clapp, B. (2020). 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes. European Heart Journal, 41(3), 407-477. https://doi.org/10.1093/eurheartj/ehz425


Knuuti, Juhani, et al. "2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes." European Heart Journal 41.3 (2020): 407-477.

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