ESC GUIDELINES2013 ESC guidelines on the management of stable coronary artery diseaseThe Task Force on the management of stable coronary artery disease of the European Society of CardiologyTask Force Members: Gilles Montalescot*(Chairperson) (France), Udo Sechtem* (Chairperson) (Germany), Stephan Achenbach (Germany), Felicita Andreotti (Italy), Chris Arden (UK), Andrzej Budaj (Poland), Raffaele Bugiardini (Italy), Filippo Crea (Italy), Thomas Cuisset (France), Carlo Di Mario (UK), J. Rafael Ferreira (Portugal), Bernard J. Gersh (USA), Anselm K. Gitt (Germany), Jean-Sebastien Hulot (France),Nikolaus Marx (Germany), Lionel H. Opie (South Africa), Matthias Pfisterer (Switzerland),EvaPrescott(Denmark),FrankRuschitzka(Switzerland),ManelSabate (Spain), Roxy Senior (UK), David Paul Taggart (UK), Ernst E. van der Wall (Netherlands), Christiaan J.M. Vrints (Belgium).ESC Committee for Practice Guidelines (CPG): Jose Luis Zamorano (Chairperson) (Spain), Stephan Achenbach (Germany), Helmut Baumgartner (Germany), Jeroen J. Bax (Netherlands), He ctor Bueno (Spain), Veronica Dean (France), Christi Deaton (UK), Cetin Erol (Turkey), Robert Fagard (Belgium), Roberto Ferrari (Italy), David Hasdai (Israel),ArnoW.Hoes(Netherlands),PaulusKirchhof(Germany/UK),JuhaniKnuuti(Finland),PhilippeKolh(Belgium), PatrizioLancellotti (Belgium),AlesLinhart (CzechRepublic),PetrosNihoyannopoulos(UK),MassimoF.Piepoli (Italy), Piotr Ponikowski (Poland), Per Anton Sirnes (Norway), Juan Luis Tamargo (Spain), Michal Tendera (Poland), Adam Torbicki (Poland), William Wijns (Belgium), Stephan Windecker (Switzerland).Document Reviewers: Juhani Knuuti (CPG Review Coordinator) (Finland), Marco Valgimigli (Review Coordinator) (Italy), He ctor Bueno (Spain), Marc J. Claeys (Belgium), Norbert Donner-Banzhoff (Germany), Cetin Erol (Turkey), Herbert Frank (Austria), Christian Funck-Brentano (France), Oliver Gaemperli (Switzerland), Jose R. Gonzalez-Juanatey (Spain), Michalis Hamilos (Greece), David Hasdai (Israel), Steen Husted (Denmark), Stefan K. James (Sweden), Kari Kervinen (Finland), Philippe Kolh (Belgium), Steen Dalby Kristensen (Denmark), Patrizio Lancellotti (Belgium), Aldo Pietro Maggioni (Italy), Massimo F. Piepoli (Italy), Axel R. Pries (Germany),*Correspondingauthors.Thetwochairmencontributedequallytothedocuments.Chairman,France:ProfessorGillesMontalescot,InstitutdeCardiologie,Pitie-SalpetriereUniversity Hospital, Bureau 2-236, 47-83 Boulevard de lHopital, 75013 Paris, France. Tel: +33 1 42 16 30 06, Fax: +33 1 42 16 29 31. Email: gilles.montalescotpsl.aphp.fr. Chairman, Germany: ProfessorUdoSechtem,Abteilungfu rKardiologie,RobertBoschKrankenhaus,Auerbachstr.110,DE-70376Stuttgart,Germany.Tel: +4971181013456,Fax:+4971181013795,Email: udo.sechtemrbk.deEntities having participated in the development of this document:ESC Associations: Acute Cardiovascular Care Association (ACCA), European Association of Cardiovascular Imaging (EACVI), European Association for Cardiovascular Prevention (ii) those previously symptomatic with known obstructive or non-obstructive CAD, who have become asymptomatic with treatment and need regular follow-up;(iii) those who report symptoms for the first time and are judged to already be in a chronic stable condition (for instance because history-taking reveals that similar symptoms were already presentforseveralmonths).Hence,SCADdefinesthedifferentevolutionary phases of CAD, excluding the situations in, which coronary artery thrombosis dominates clinical presentation (acute coronary syn- dromes).However, patients who have a first or recurrent manifestation of anginabutcanbecategorizedashavingalow-riskacutecoronarysyn- drome(ACS)accordingtothecurrentACSguidelinesoftheESCno recurrenceofchestpain,nosignsofheartfailure,noabnormalitiesin the resting electrocardiogram (ECG), no rise in markers of myocar- dial necrosis (preferably troponin) and hence are not candidates for swift intervention1should also be managed according to the algo- rithms presented in these Guidelines. Although routine screening of asymptomatic patients is discouraged,2these guidelines can alsobeappliedtoasymptomaticpatientspresentingforfurtherevaluation duetoanabnormaltest.ThescopeofthepresentGuidelines,there- fore, spans from asymptomatic individuals to patients after stabilisa- tion of an ACS. ThetraditionalunderstandingofSCADisthat ofadiseasecausing exercise- and stress-related chest symptoms due to narrowings of 50% in the left main coronary artery and 70% in one or several of the major coronary arteries. Compared with the previous version of the Guidelines3, the present edition considers not only such atheroscleroticnarrowings,butalsomicrovasculardysfunction andcoronaryvasospasminthediagnosticandprognosticalgorithms; the present Guidelines also distinguish diagnostic testing from prog- nostic assessment; they give increased importance to the pre-testprobability (PTP) of disease strongly influencing the diagnostic algo- rithmsandtheytakeint