Until recently, coronary revascularization with coronary artery bypass grafting or percutaneous coronary intervention has been regarded as the standard choice for stable coronary artery disease (CAD), particularly for patients with a significant burden of ischemia. However, in conjunction with remarkable advancements in adjunctive medical therapy and a deeper understanding of its long-term prognosis from recent large-scale clinical trials, including ISCHEMIA, the approach towards stable CAD has changed drastically. Although the updated evidence from recent randomized clinical trials will likely modify the recommendations for future clinical practice guidelines, there are still unresolved and unmet issues in Asia, where the prevalence and practice patterns are markedly different from those in Western countries. Herein, we discuss the perspectives on (1) assessing the diagnostic probability of stable CAD patients, (2) application of non-invasive imaging tests, (3) initiation and titration of medical therapy, and (4) evolution of revascularization procedures in the modern era.

JACC: Asia Editor-in-Chief 

Jian’an Wang, MD, PhD, FACC

CME Editor 

Kenneth A. Ellenbogen, MD

Authors
Shun Kohsaka, MD

Kentaro Ejiri, MD

Hidenobu Takagi, MD

Ippei Watanabe, MD

Yodo Gatate, MD

Kenji Fukushima, MD

Shintaro Nakano, MD

Taishi Hirai, MD

Important Dates

Date of Release: February 21, 2023
Term of Approval/Date of CME/MOC Expiration: February 20, 2024