Do not perform an ischemia induction test in the follow-up of chronic coronary syndromes in the stable and asymptomatic patient.

Type of practice

Cardiological tests

Topic Area


In chronic coronary syndromes, with preserved left ventricular function, coronary revascularization aims to control symptoms and does not affect the prognosis. In stable and asymptomatic patients, ischemia research tests are not indicated and increase the risk of inappropriate invasive treatments; the first-line treatment is conservative, based on aggressive control of risk factors.


1. Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 2020;41:407-77.
2. Boden WE, O’Rourke RA, Teo KK, et al.; COURAGE Trial Research Group. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007;356:1503-16.
3. Maron DJ, Hochman JS, Reynolds HR, et al. Initial invasive or conservative strategy for stable coronary disease. New England Journal of Medicine 2020; 382:1395-407.



Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.