Chronic coronary syndromes (CCS), of which angina pectoris is an important symptom, have a major societal impact, affecting our patients’ quality of life with reduced physical endurance, mental depression, and recurrent hospitalizations and office visits.

CCS are seen as stable, differentiated from acute coronary syndromes (ACS) where the disease has become destabilized with partial or complete coronary occlusion resulting in NSTEMI or STEMI.

Until recently, there was little evidence for the prognostic impact of percutaneous coronary interventions (PCIs) using modern drug-eluting stent (DES) implantation vs medical therapy in the treatment of patients presenting with CCS. However, some of these previous trials did not use the latest-generation DES technology (which offers thinner struts or limus derivatives for antiproliferation). In these trials, only modest benefits were observed in terms of survival or myocardial infarction, although there was improvement of symptoms and quality of life.

Today, this is changing with new and emerging evidence coming out of trials using the latest imaging technology and devices, as well as following patients over the long-term.