Functional Testing to Reduce Unnecessary Angiography?

Functional testing of stable patients with suspected coronary heart disease may avoid unnecessary angiography without significant increases in major adverse coronary events.

Patients with suspected coronary heart disease (CHD) and a high pretest probability (PP) of disease often undergo invasive angiography, but can functional testing reduce “unnecessary” angiograms that do not show significant obstructive coronary disease? In the CE-MARC 2 study, 1202 stable patients aged ≥30 with chest pain and suspected CHD (range of PP based on Duke scoring, 10%–90%; mean, 50%) from six centers in the U.K. were randomized to three strategies for guiding care:

1. Functional testing with cardiac magnetic resonance (CMR),

2. Functional testing with myocardial perfusion scintigraphy (MPS), or

3. The U.K. National Institute for Health Care (NICE) guidelines, which send lower-risk patients (PP, 10%–29%) predominantly to coronary com…

Reviewing Author

Kirsten E. Fleischmann, MD, MPH

Disclosures

Grant/Research SupportNational Institutes of Health

Leadership Positions in Professional SocietiesAmerican College of Cardiology/American Heart Association

Kirsten E. Fleischmann, MD, MPH

Disclosures

Grant/Research SupportNational Institutes of Health

Leadership Positions in Professional SocietiesAmerican College of Cardiology/American Heart Association

Functional Testing to Reduce Unnecessary Angiography?

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Reviewing Author