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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2019年ESC慢性冠脉综合征诊断与管理指南

冠状动脉疾病（CAD）是一种以心外膜动脉粥样硬化斑块积聚为特征的病理过程，无论是阻塞性还是非阻塞性。这个过程可以通过生活方式调整、药物治疗和旨在实现疾病稳定或消退的侵入性干预来改变。该疾病可能有较长的稳定期，但也可能随时变得不稳定，通常是由于斑块破裂或侵蚀引起的急性动脉粥样硬化血栓形成事件。然而，这种疾病是慢性的，通常是进行性的，因此很严重，即使在临床上明显的静止期也是如此。CAD 过程的动态特性导致各种临床表现，可以方便地将其归类为急性冠脉综合征 (ACS) 或慢性冠脉综合征 (CCS)。此处介绍的指南涉及 CCS 患者的管理。CCS 的自然历史如图 1 所示。