Outcomes of anatomical vs. functional testing for coronary artery disease : Lessons from the major trials.

Outcomes of anatomical vs. functional testing for coronary artery disease : Lessons from the major trials. Herz. 2020 Jun 05;: Authors: Karády J, Taron J, Kammerlander AA, Hoffmann U Abstract Management of patients presenting with suspected stable coronary artery disease (CAD) are challenging because estimation of pretest probability for obstructive CAD remains difficult. In addition, identification of those who benefit from coronary revascularization remains ineffective regardless of the wide array of noninvasive testing alternatives available. Functional testing, which has long been considered to be the test of choice to risk stratify these patients, shows modest agreement with CAD severity detected by invasive coronary angiography and has been reported to be ineffective in settings of low prevalence of obstructive CAD. A growing body of evidence demonstrates the excellent diagnostic accuracy as well as prognostic value of coronary computed tomography (CT) angiography especially in conjunction with noninvasive fractional flow reserve (FFR) testing, challenging the primary role of functional testing especially in patients without prior or known CAD. Landmark trials, including the Prospective Multicenter Imaging Study for Evaluation of chest pain (PROMISE) and Scottish Computed Tomography of the Heart (SCOT-HEART), have contributed to a better understanding of how coronary CT angiography may play a role in more efficient manageme...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research