2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease
The US counterpart to the ESC's chronic coronary syndrome guideline, published a year earlier and drawing sharper conclusions in two places. Beta-blockers: routine long-term beta-blockade after myocardial infarction is dropped unless LVEF is ≤40% (or there is another indication) — the ESC 2024 CCS document is more permissive. Cardiometabolic therapy: SGLT2 inhibitors and GLP-1 receptor agonists are recommended in chronic coronary disease with type 2 diabetes, and low-dose colchicine gets a 2b for residual inflammatory risk. On revascularisation both societies land in the same place after ISCHEMIA — it relieves angina, it does not prolong life in stable disease with preserved ejection fraction. The register's trials are grouped by theme below.
This guideline cites 19 of the 199 landmark trials in our Cardiology register.
Revascularisation vs. medical therapy8
- 2022REVIVED-BCIS2Cardiology · Coronary · PCI vs OMTREVascularization for Ischemic VEntricular Dysfunction — British Cardiovascular Intervention Society-2
- 2020ISCHEMIACardiology · Coronary · RevascularisationInternational Study of Comparative Health Effectiveness with Medical and Invasive Approaches
- 2018ORBITACardiology · Coronary · RevascularisationObjective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty
- 2016STICHCardiology · HF · CABGSurgical Treatment for Ischemic Heart Failure — Extension Study (STICHES, 10-year follow-up)
- 2012FAME 2Cardiology · Coronary · FFR-guided PCIFractional flow reserve versus Angiography for Multivessel Evaluation 2
- 2012FREEDOMCardiology · Coronary · PCI vs CABGFuture REvascularization Evaluation in patients with Diabetes mellitus: Optimal management of Multivessel disease
- 2009SYNTAXCardiology · Coronary · PCI vs CABGSYNergy between percutaneous coronary intervention with TAXUS and Cardiac Surgery
- 2007COURAGECardiology · Coronary · RevascularisationClinical Outcomes Utilising Revascularisation and Aggressive Drug Evaluation
Antithrombotic therapy2
Lipid-lowering & anti-inflammatory therapy5
- 2019REDUCE-ITCardiology · Lipids · TriglyceridesReduction of Cardiovascular Events with Icosapent Ethyl
- 2018ODYSSEY OUTCOMESCardiology · Lipids · PCSK9 inhibitorEvaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab
- 2017FOURIERCardiology · Lipids · PCSK9iFurther Cardiovascular Outcomes Research with PCSK9 Inhibition
- 2017CANTOSCardiology · Lipids · Anti-inflammatoryCanakinumab Anti-inflammatory Thrombosis Outcomes Study
- 2015IMPROVE-ITCardiology · Lipids · Non-statin LDLImproved Reduction of Outcomes: Vytorin Efficacy International Trial
Cardiometabolic therapy (SGLT2i, GLP-1 RA)4
- 2019DECLARE-TIMI 58Cardiology · Cardiometabolic · SGLT2 inhibitorsDapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes
- 2016LEADERCardiology · Cardiometabolic · GLP-1 RALiraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results
- 2016SUSTAIN-6Endocrinology · GLP-1 RA · CV outcome trialTrial to Evaluate CV and Other Long-term Outcomes with Semaglutide
- 2015EMPA-REG OUTCOMECardiology · Cardiometabolic · SGLT2 inhibitorsEmpagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes
Published since the guideline4
- 2025REBOOTCardiology · Coronary · beta-blockerTREatment with Beta-blockers after myOcardial infarction withOut reduced ejection fracTion (REBOOT-CNIC)
- 2024REDUCE-AMICardiology · Coronary · beta-blockerRandomized Evaluation of Decreased Usage of Beta-Blockers after Acute Myocardial Infarction
- 2023ORBITA-2Cardiology · Coronary · RevascularisationA Placebo-Controlled Trial of PCI for Stable Angina
- 2023SELECTCardiology · Cardiometabolic · GLP-1 RASemaglutide and Cardiovascular Outcomes in Obesity without Diabetes