Search

In 2019, the European Society for Cardiology (ESC) published guidelines with a new term, "chronic coronary syndromes" (CCS). These guidelines presented 6 clinical scenarios, which are most common in outpatient practice. The diagnostic approach described in these guidelines shifts from the standardization to the rationality of individualized solutions on using various diagnostic methods. The diagnostic approach suggested in the ESC guidelines requires extensive medical discussion and consensus because this will definitely entail a) further increase in indexes that reflect the morbidity of ischemic heart disease (IHD) due to unconfirmed diagnoses and b) administration of unreasoned therapy. This article presents statements of the guidelines, which cannot be automatically transmitted to the existing medical practice and should be discussed and adjusted by experts of the Russian Society of Cardiology.

Ischemic heart disease (IHD) occurring at age less than 55 in men and less than 65 years in women is designated as premature IHD. However, in different studies these age limits vary from 35 years to 65 years. Among the population of working age in the Russian Federation mortality from IHD is several times higher than in the US and Europe. Patients with premature IHD differ from the elderly in structure of risk factors, clinical manifestations and prognosis. Smoking, obesity and family history of premature IHD are more common in young patients with IHD while diabetes and hypertension are less common.