[Diagnostics, therapy and the importance of quality of life in patients with chronic coronary syndrome. Results oft the general practitioner care study ALTHEA].

Background: The clinical picture of coronary artery disease has changed considerably in past years. As a consequence, the medical condition was re-defined in 2019 as "chronic coronary syndrome" (CCS). In view of these developments, the primary aim of the ALTHEA study was to gain current insights into the management of patients with CCS and stable angina in German primary care settings.

Method: ALTHEA is a national, cross-sectional study that used a structured 10-item-questionaire containing single-choice and multiple-choice questions on diagnosis, symptomatic therapy and quality of life of patients with suspected or confirmed CCS and stable angina. Interviewees were primary care practitioners (PCPs) from Germany.

Results: Interviews were conducted between April and September 2021. In total 1,050 PCPs were asked country-wide, aimed at achieving a representative sample. Of the 1,050 PCPs 1,021 replied. The majority of respondents indicated that they would carry out instrument-based diagnostic tests on their own, including a stress electrocardiogram, if CCS was suspected. Regarding treatment goals, the majority of the interviewees gave more relevance to an enhanced quality of life compared to prognostic improvements. In addition, most participants stated that they independently initiate and control symptomatic therapy in patients with suspected CCS and stable angina. Amongst the available antianginal medications, the interviewees showed preferences in terms of efficacy (betablockers), tolerability (ranolazine) and effect on quality of life (ranolazine).

Conclusions: The cross-sectional study shows that PCPs currently serve as relevant guides to cardiologists in the care of patients with suspected CCS and stable angina. PCPs provide support in several areas such as diagnosis and symptomatic therapy, in part intersecting with cardiologists' tasks. Hence the study reveals a close link between primary care and cardiology in the management of patients with CCS.