Chronic stable angina risk stratification by coronary angiography

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Risk calculators and risk factors for Chronic stable angina risk stratification by coronary angiography

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Smita Kohli, M.D.;Aysha Aslam, M.B.B.S[3]

ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina (DO NOT EDIT))[1]

AHA Guidelines for Coronary Angiography for Risk Stratification in SIHD(DO NOT EDIT)[1]

Coronary Angiography as an Initial Testing Strategy to Assess Risk

Class I
"1. Patients with SIHD who have survived sudden cardiac death or potentially life-threatening ventricular arrhythmia should undergo coronary angiography to assess cardiac risk. (Level of Evidence: B)"
"1. Patients with SIHD who develop symptoms and signs of heart failure should be evaluated to determine whether coronary angiography should be performed for risk assessment. (Level of Evidence: B)"

Coronary Angiography to Assess Risk After Initial Workup With Noninvasive Testing

Class I
"1. Coronary arteriography is recommended for patients with SIHD whose clinical characteristics and results of noninvasive testingindicate a high likelihood of severe IHD and when the benefits are deemed to exceed risk. (Level of Evidence: C)"
Class IIa
"1. Coronary angiography is reasonable to further assess risk in patients with SIHD who have depressed LV function (ejection fraction < 50%) and moderate risk criteria on noninvasive testing with demonstrable ischemia. (Level of Evidence: C)"
"2. Coronary angiography is reasonable to further assess risk in patients with SIHD and inconclusive prognostic information after noninvasive testing or in patients for whom noninvasive testing is contraindicated or inadequate. (Level of Evidence: C)"
"3. Coronary angiography for risk assessment is reasonable for patients with SIHD who have unsatisfactory quality of life due to angina, have preserved LV function (ejection fraction >50%), and have intermediate risk criteria on noninvasive testing. (Level of Evidence: C)"
Class III
"1. Coronary angiography for risk assessment is not recommended in patients with SIHD who elect not to undergo revascularization or who are not candidates for revascularization because of comorbidities or individual preferences. (Level of Evidence: B)"
"2. Coronary angiography is not recommended to further assess risk in patients with SIHD who have preserved LV function (ejection fraction >50%) and low-risk criteria on noninvasive testing. (Level of Evidence: B)"
"3. Coronary angiography is not recommended to assess risk in patients who are at low risk according to clinical criteria and who have not undergone noninvasive risk testing. (Level of Evidence: C)"
"4. Coronary angiography is not recommended to assess risk in asymptomatic patients with no evidence of ischemia on noninvasive testing. (Level of Evidence: C)"'

References

  1. 1.0 1.1 Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP; et al. (2012). "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 126 (25): 3097–137. doi:10.1161/CIR.0b013e3182776f83. PMID 23166210.

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