2023 Guideline for Chronic Coronary Disease

The updated American guideline provides an evidence-based and patient-centered approach to management of patients with chronic coronary disease (CCD). The guideline is based on a comprehensive literature search from September 2021 to May 2022 and includes the following top take-home messages: Emphasis is on team-based, patient-centered care. Nonpharmacological therapies, including healthy dietary habits and exercise, are recommended for
all patients. Habitual physical activity is encouraged. Use of sodium glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists are recommended for selected groups of patients. Long-term beta-blocker therapy is not recommended to improve outcomes in patients with CCD in the absence of myocardial infarction in the past year, left ventricular ejection fraction ≤50%, or another primary indication for beta-blocker therapy; either a calcium channel blocker or beta blocker is recommended as first-line antianginal therapy. Statins remain first line therapy for lipid lowering. Shorter durations of dual antiplatelet therapy are safe and effective in many circumstances. The use of nonprescription or dietary supplements, including fish oil and omega-3 fatty acids or vitamins, is not recommended. Routine periodic anatomic or ischemic testing without a change in clinical or functional status is not recommended for risk stratification or to guide therapeutic decision-making. E-cigarettes are not recommended as first-line therapy for smoking cessation. Source: https://www.ahajournals.org/