We invite World Heart Federation members and partners to share their perspective on how coronary artery disease (CAD) is detected and treated outside the setting of an acute coronary syndrome- in people with stable symptoms as well as those with no symptoms at all- in their country or region. Your input will directly shape a WHF roadmap focused on making detection and treatment equitable and scalable across high-, middle-, and low-income settings.
Why this matters. Coronary artery disease develops silently long before an acute event — yet too often it is recognised only when a heart attack or sudden death occurs. For people who do have symptoms, such as chest pain or shortness of breath, what happens next varies widely between and within countries: which investigation is available, how quickly it is done, and whether the findings translate into effective long-term treatment. Others have no symptoms at all, yet harbour advanced and dangerous disease. Symptoms can be an unreliable guide to the severity of underlying disease: silent CAD is not mild CAD- it is undetected CAD, and it may be of any severity. This matters more than ever, because we now have treatments that can halt the progression of atherosclerosis and dramatically reduce heart attacks and death- yet in practice these have been reserved almost entirely for people who have already suffered and survived a heart attack. Detecting disease earlier is what allows that same proven protection to be offered before the event, rather than only to those who survive it. This consultation is concerned with CAD away from the setting of an acute coronary syndrome, in both groups- not with the emergency management of a heart attack. It asks how we can find and treat that disease earlier, and more fairly, everywhere.
How your input will be used. Your answers will do more than describe the situation in your own setting. Taken together, responses from across the WHF membership will show where detection and treatment currently fall short, and for whom- the variation between and within countries that published data rarely capture. That evidence will shape the roadmap's practical recommendations: what a workable pathway looks like where resources are constrained, how proven care can be scaled without widening inequity, and which measures would show whether quality of care and outcomes are genuinely improving. Where your setting has found approaches that work, we would like them to inform what we recommend to others.
Please feel free to forward this survey to others in your country or region working to reduce the burden of CAD, including clinicians, public health and policy colleagues, NGOs, and patient representatives.
The survey takes approximately 10–15 minutes. Questions marked * are required. If you have any questions, please contact Lana Raspail at lana.raspail@worldheart.org.
Co-chairs: Professor Gemma Figtree and Professor George Mensah (World Heart Federation).
