A1 Journal article – refereed

EACVI survey on investigations and imaging modalities in chronic coronary syndromes




List of Authors: Bularga A, Saraste A, Fontes-Carvalho R, Holte E, Cameli M, Michalski B, Williams MC, Podlesnikar T, D'Andrea A, Stankovic I, Mills NL, Manka R, Newby DE, Schultz-Menger J, Haugaa KH, Dweck MR

Publisher: OXFORD UNIV PRESS

Publication year: 2021

Journal: EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging

Journal name in source: EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING

Journal acronym: EUR HEART J-CARD IMG

Volume number: 22

Issue number: 1

Number of pages: 7

ISSN: 2047-2404

eISSN: 2047-2412

DOI: http://dx.doi.org/10.1093/ehjci/jeaa300

URL: https://academic.oup.com/ehjcimaging/article/22/1/1/5961505


Abstract
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.

Downloadable publication

This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail. Please cite the original version.




Last updated on 2021-24-06 at 09:21