Appropriate Use Criteria and Yield of Coronary Angiography

Appropriate use criteria (AUC) have been developed for several cardiac procedures, including angiography (J Am Coll Cardiol 2012; 59:1995). Canadian investigators used data from 19 hospitals in Ontario to assess the relation of AUC and the presence of obstructive coronary artery disease (CAD; defined as luminal obstruction of ≥70% or left main artery obstruction of ≥50%) in patients with stable angina.

In >48,000 patients without known CAD, 58% of all angiograms were deemed to be appropriate, whereas 31% were of “uncertain” appropriateness, and the remainder were deemed to be inappropriate. In patients whose angiograms were categorized as appropriate, 53% had obstructive CAD, and 40% underwent revascularization. In patients whose angiograms …