|
Study |
Risk | ||
|
High |
Intermediate |
Low | |
|
ECG stress testa |
Annual cardiovascular mortality | ||
|
>3% |
1%-3% |
<1% | |
|
Imaging studies |
Area of ischemia | ||
|
>10%b |
1%-10%c |
– | |
|
Coronary CTA |
Coronary lesions | ||
|
Significant stenosisd |
Significant stenosise |
Normal coronary arteries or atherosclerotic plaques only | |
|
a Risk assessment using the Duke treadmill score including exercise workload in time expressed in metabolic equivalents, ST-T changes during and after exercise, and clinical symptoms (no angina, angina, or angina causing discontinuation of the test). Calculator available at www.cardiology.org/tools/medcalc/duke. b >10% in SPECT; the quantitative data for MRI are limited: probably ≥2 segments (out of 16) with new areas of hypoperfusion; ≥3 segments (out of 17) with dysfunction caused by dobutamine; or ≥3 segments (out of 17) with abnormal wall motion observed on stress echocardiography. c Or any ischemia rated as lower than high-risk on MRI of the heart or stress echocardiography. d That is, 3-vessel disease with proximal stenosis of the large coronary arteries, stenosis of the left main coronary artery, or proximal stenosis of the LAD. e Non–high-risk stenosis of proximal large coronary arteries. | |||
|
Adapted from Eur Heart J. 2013;34(38):2949-3003. | |||
|
CTA, computed tomography angiography; ECG, electrocardiography; LAD, left anterior descending artery; MRI, magnetic resonance imaging; SPECT, single-photon emission computed tomography. | |||