Pharmacotherapy in Chronic Coronary Syndromes: Current Evidence and Future Directions.

Chronic coronary syndromes (CCS) constitute a dynamic and heterogeneous spectrum of clinical manifestations that necessitate a comprehensive, patient-centered, and multidisciplinary management approach. Recent international guidelines for the management of patients with chronic coronary disease underscore a dual therapeutic paradigm that integrates rigorous, evidence-based lifestyle modifications with precisely targeted pharmacological interventions to optimize long-term cardiovascular outcomes. Non-pharmacological lifestyle strategies—such as structured exercise programs, dietary optimization, smoking cessation, and psychosocial support—form the cornerstone of cardiovascular risk reduction and have been shown to exert synergistic benefits when combined with pharmacotherapy. This narrative review aims to synthesize and critically appraise current evidence and consensus recommendations on the pharmacological management of CCS, with particular emphasis on mechanisms of action, comparative clinical effectiveness, safety profiles, and the evolving landscape of emerging therapies. The discussion encompasses established drug classes, including antianginal agents, lipid-lowering therapies, antithrombotic agents, and neurohormonal modulators, while also examining novel compounds such as proprotein convertase subtilisin/kexin type ۹ (PCSK۹) inhibitors, inclisiran, and bempedoic acid, which represent significant advances in lipid management. By integrating findings from recent landmark clinical trials with guideline-directed recommendations, this manuscript delivers a comprehensive and clinically relevant overview intended to inform and support the decision-making of cardiologists, clinical pharmacists, and researchers engaged in the field of cardiovascular therapeutics.

کلیدواژه ها:

Chronic coronary syndrome ، Cardiology ، Pharmacy ، Lipid-lowering therapy ، PCSK۹ inhibitors ، lifestyle modification