The chronic coronary syndromes (CCS) include patients with a classic history of angina pectoris in the presence of either risk factors for or known atherosclerotic coronary artery disease. Randomized, controlled trials conducted in the optimal medical therapy (OMT) era have convincingly demonstrated that adherence to the outdated paradigm focused on treatment of obstructive coronary disease with initial revascularization fails to reduce death or myocardial infarction and inconsistently reduces angina symptoms. Rather, OMT reduces events and improves symptoms and should be considered first-line treatment for patients with CCS.

中文翻译：

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最佳药物治疗作为慢性冠状动脉综合征的一线治疗：COURAGE、BARI 2D、FAME 2 和 ISCHEMIA 的经验教训

慢性冠状动脉综合征 (CCS) 包括具有典型心绞痛病史且存在冠状动脉粥样硬化疾病的危险因素或已知动脉粥样硬化性冠状动脉疾病的患者。在最佳药物治疗 (OMT) 时代进行的随机对照试验令人信服地证明，坚持以初始血运重建治疗阻塞性冠状动脉疾病为重点的过时范式并不能减少死亡或心肌梗塞，并且始终不能减少心绞痛症状。相反，OMT 可减少事件并改善症状，应被视为 CCS 患者的一线治疗。