Is angioplasty still needed in chronic coronary syndromes ?

Coronary angioplasty has emerged in recent years as a remarkable technique for improving survival and recurrence of infarction in acute coronary syndromes. Its results in chronic coronary syndromes are more controversial. The results of the very large study on this subject, the ISCHEMIA study, deserve to be carefully analysed. Indeed, chronic coronary syndromes include stable angina and silent ischaemia. These are very frequent reasons for consultation in contemporary clinical cardiology. The whole strategy of screening and treatment of these coronary syndromes is at stake, which represent a major health issue. Screening for coronary disease is currently based either on tests to detect myocardial ischaemia or on the coroscan, which allows morphological detection of coronary stenosis. But if coronary angioplasty were not beneficial in chronic coronary syndromes, would screening for possible lesions still be useful? These are all exciting and topical questions that will be addressed