About this Research Topic
Coronary revascularization can be offered to a patient through coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), or sometimes a hybrid invasive approach. While invasive strategies have proven profoundly effective in reducing mortality, morbidity, and symptoms in the setting of acute coronary syndrome, their role in patients with CCS compared to conservative therapy is less clear. In this patient population, coronary revascularization is largely reserved for those with unacceptable and limiting angina despite conservative therapy, significant left ventricular systolic dysfunction, or high-risk coronary anatomy.
The aim of this Research Topic is to gather contributions from clinical and translational researchers worldwide on the challenges and advancements in diagnosing, managing, and risk-stratifying patients with chronic coronary syndrome (CCS).
Goals:
• Diagnosis and Management:
o Identify which CCS patients benefit most from revascularization.
o Determine criteria for revascularization in patients with severe left ventricular systolic dysfunction.
• Risk Stratification:
o Explore factors influencing revascularization decisions (myocardial viability, scar burden, coronary anatomy, symptom severity, and ischemia).
o Assess the impact of non-cardiac comorbidities, age, and quality of life on decision-making.
• Non-Invasive Testing:
o Investigate the role of exercise tests and non-invasive imaging in risk stratification and coronary disease detection.
• Medical Therapy:
o Evaluate the efficacy of anti-ischemic, antithrombotic, and other drugs for CCS.
o Optimize conservative medical therapy for individual patients.
• Special Populations:
o Address the challenges in diagnosing and treating patients with microvascular or vasospastic angina without obstructive epicardial coronary disease.
o Address the challenges in diagnosing and treating patients with chronic total occlusion (CTO) in the setting of CCS.
• Research Advancement:
o Enhance understanding of CCS complexities in clinical practice through collaborative research and shared-decision making.
We invite all interested researchers involved in CCS research to submit their work. This includes:
• Original studies in the field of CCS, such as those dealing with the diagnosis and quantification of coronary disease burden using intravascular imaging methods like intravascular ultrasound (IVUS) or optical coherence tomography (OCT), and imaging-guided PCI in CCS.
• Papers focused on different management strategies in CCS, particularly those reporting important outcome data such as mortality, recurrent hospitalizations, angina occurrence, and quality of life.
• We are especially interested in clinical studies investigating various devices in CCS, such as coronary sinus reducers, drug-coated balloons, third-generation drug-eluting stents, calcium-modification methods, and similar innovations.
• Additionally, we welcome data derived from big-data research in this setting, including nationwide datasets or information from multicentric registries.
• Manuscripts focused on the diagnosis and management of non-obstructive CCS conditions, such as microvascular and/or vasospastic angina, are of particular interest due to substantial evidence gaps in this domain.
• Manuscripts focused on the diagnosis and management of special and complex populations within the CCS spectrum such as patients with chronic total occlusion (CTO).
• Up-to-date, state-of-the-art review articles on relevant CCS topics with large uncertainties or high levels of debate are also cordially invited for submission.
• Finally, we will consider translational research papers on a case-by-case basis.
Keywords: chronic coronary syndrome, Optimal medical therapy, OMT, Percutaneous coronary intervention, Stable angina
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.