scholarly journals Stable coronary artery disease management: What has changed in the 2013 European Society of Cardiology guideline?

2014 ◽  
Vol 42 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Emre Ozpelit
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Disease Management ◽  
European Society ◽  
Stable Coronary Artery Disease ◽  
Artery Disease ◽  
European Society Of Cardiology ◽  
Cardiology Guideline

Validation of the European Society of Cardiology pre-test probability model for obstructive coronary artery disease

2020 ◽  
Author(s):  
Simon Winther ◽  
Samuel Emil Schmidt ◽  
Laust Dupont Rasmussen ◽  
Luis Eduardo Juárez Orozco ◽  
Flemming Hald Steffensen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
European Society ◽  
Probability Model ◽  
Invasive Coronary Angiography ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease ◽  
European Society Of Cardiology ◽  
Test Probability

Abstract Aims  Estimation of pre-test probability (PTP) of disease in patients with suspected coronary artery disease (CAD) is a common challenge. Due to decreasing prevalence of obstructive CAD in patients referred for diagnostic testing, the European Society of Cardiology suggested a new PTP (2019-ESC-PTP) model. The aim of this study was to validate that model. Methods and results  Symptomatic patients referred for coronary computed tomography angiography (CTA) due to suspected CAD in a geographical uptake area of 3.3 million inhabitants were included. The reference standard was a combined endpoint of CTA and invasive coronary angiography (ICA) with obstructive CAD defined at ICA as a ≥50% diameter stenosis or fractional flow reserve ≤0.80 when performed. The 2019-ESC-PTP, 2013-ESC-PTP, and CAD Consortium basic PTP scores were calculated based on age, sex, and symptoms. Of the 42 328 identified patients, coronary stenosis was detected in 8.8% using the combined endpoint. The 2019-ESC-PTP and CAD Consortium basic scores classified substantially more patients into the low PTP groups (PTP < 15%) than did the 2013-ESC-PTP (64% and 65% vs. 16%, P < 0.001). Using the combined endpoint as reference, calibration of the 2019-ESC-PTP model was superior to the 2013-ESC-PTP and CAD Consortium basic score. Conclusion  The new 2019-ESC-PTP model is well calibrated and superior to the previously recommended models in predicting obstructive stenosis detected by a combined endpoint of CTA and ICA.

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