EACVI survey on investigations and imaging modalities in chronic coronary syndromes

• Type: Article in International Scientific Journal
• Date: 2021

Authors

Bularga, A (Author) Other; Saraste, A (Author) Other; Fontes-Carvalho R (Author) FMUP; Holte, E (Author) Other; Cameli, M (Author) Other; Michalski, B (Author) Other; Williams, MC (Author) Other; Podlesnikar, T (Author) Other; D'Andrea, A (Author) Other; Stankovic, I (Author) Other; Mills, NL (Author) Other; Manka, R (Author) Other; Newby, DE (Author) Other; Schultz Menger, J (Author) Other; Haugaa, KH (Author) Other; Dweck, MR (Author) Other

Journal

Title: European Heart Journal Cardiovascular Imaging

Vol. 22

Pages: 1-7

ISSN: 2047-2404

Publisher: Oxford University Press

Indexing

ISI Web of Knowledge - 12 Citations

Scopus - 13 Citations

Other information

Authenticus ID: P-00T-AFS

DOI: 10.1093/ehjci/jeaa300

Abstract (EN): Aims The European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee performed a global survey to evaluate current practice for the assessment and management of patients with suspected and confirmed chronic coronary syndromes. Methods and results One-hundred and ten imaging centres from 37 countries across the world responded to the survey. Most non-invasive investigations for coronary artery disease were widely available, except cardiovascular magnetic resonance (available 40% centres). Coronary computed tomography angiography (CCTA) and nuclear scans were reported by a multi-disciplinary team in only a quarter of centres. In the initial assessment of patients presenting with chest pain, only 32% of respondents indicated that they rely on pre-test probability for selecting the optimal imaging test while 31% proceed directly to CCTA. In patients with established coronary artery disease and recurrent chest pain, respondents opted for stress echocardiography (27%) and nuclear stress perfusion scans (26%). In asymptomatic patients with coronary artery disease and an obstructive (>70%) right coronary artery stenosis, 58% of respondents were happy to pursue medical therapy without further testing or intervention. This proportion fell to 29% with left anterior descending artery stenosis and 1% with left main stem obstruction. In asymptomatic patients with evidence of moderate-to-severe myocardial ischaemia (15%), only 18% of respondents would continue medical therapy without further investigation. Conclusion Despite guidelines recommendations pre-test probability is used to assess patients with suspected coronary artery in a minority of centres, one-third of centres moving directly to CCTA. Clinicians remain reticent to pursue a strategy of optimal medical therapy without further investigation or intervention in patients with controlled symptoms but obstructive coronary artery stenoses or myocardial ischaemia.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7