Ischemia and Anatomy in the New 2024 European Guidelines for Chronic Coronary Syndromes: Update and Comparison of Recommendations.

The new 2024 European guideline on chronic coronary syndromes (CCS) is a pivotal document for clinical practice, updating the evidence and indications after five years, incorporating insights from the paradigm-shifting ISCHEMIA trial. This article explores the evolving role of functional and anatomical testing in assessing coronary artery disease (CAD), highlighting the introduction of a new risk probability score based on clinical and risk factors. Additionally, it provides a detailed comparison between these European recommendations and those from the most influential American guidelines, emphasizing key differences in the approach to risk stratification and diagnostic strategies.