Abstract:
OBJECTIVE:In response to the growing use of imaging-based cardiac stress tests in the evaluation of stable ischemic heart disease, professional societies have developed appropriate use criteria (AUC). AUC will soon be linked to reimbursement of advanced diagnostic imaging for Medicare beneficiaries via Clinical Decision Support Mechanisms (CDSMs). We sought to characterize the frequency and type of stress test utilization for chest pain referrals evaluated by cardiologists and determine appropriateness. METHODS:We conducted a retrospective review of new patient referrals seen by general cardiologists at an academic medical center between 2016 and 2017 for a diagnosis of chest pain or angina. Type of stress test ordered, if any, and its appropriateness (Appropriate, May be appropriate, and Rarely appropriate) were ascertained based on the 2013 multimodality AUC guideline document. RESULTS:There were 535 total outpatients. After applying exclusion criteria, there were 349 patients in the sample; the average age was 52 ± 15 years and 53% were female. Most chest pain was nonanginal (65%). Pretest probability of CAD was most commonly intermediate (54%). A total of 183 patients (52%) were referred for stress testing. The majority of stress tests were considered appropriate (82%) by AUC. CONCLUSION:Most patients referred to cardiologists for evaluation of chest pain or angina had nonanginal chest pain and an intermediate pretest probability of CAD. Stress testing was ordered in about half of these patients and the majority were considered appropriate by AUC. These findings suggest that indiscriminate use of CDSMs may not be warranted.
journal_name
Coron Artery Disjournal_title
Coronary artery diseaseauthors
Lam DH,Tiwana J,Li S,Kirkpatrick JN,Cheng RKdoi
10.1097/MCA.0000000000000928subject
Has Abstractpub_date
2020-08-13 00:00:00eissn
0954-6928issn
1473-5830pub_type
杂志文章abstract:BACKGROUND:The high-frequency contribution (i.e. 60-120 Hz) within the QRS complex of the surface ECG is supposed to be related to the arrhythmogenic substrate underlying sustained ventricular tachycardia in patients with coronary artery disease. One of the factors that prevents a wider clinical application of spectral...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199403000-00011
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:The 2015 American College of Cardiology/American Heart Association update on primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) recommended PCI of the non-infarct-related artery at the time of primary PCI (class IIb recommendation). Despite ev...
journal_title:Coronary artery disease
pub_type: 杂志文章,meta分析
doi:10.1097/MCA.0000000000000578
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Lymphocyte-to-monocyte ratio (LMR) is involved in all stages of coronary atherosclerosis and related to coronary artery disease (CAD). However, the correlation between LMR and the coronary plaque burden of CAD is not clearly elucidated. Therefore, this study aimed to investigate their correlation in patients...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000857
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVES:Our aim was to investigate the safety and efficacy of transradial approach, predictors of bleeding complications, and choice of radial access site in a real-life setting using a contemporary European registry of percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI). BACKGROU...
journal_title:Coronary artery disease
pub_type: 杂志文章,多中心研究
doi:10.1097/MCA.0b013e32833aa6d1
更新日期:2010-08-01 00:00:00
abstract::The patient population with the need for oral anticoagulation to reduce stroke risk associated with atrial fibrillation (AF) and dual antiplatelet therapy to prevent stent thrombosis and myocardial infarction after percutaneous coronary intervention is increasing. However, patients treated with a triple therapy consis...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/MCA.0000000000000549
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To evaluate immediate changes in left ventricular wall motion in patients treated using Biosense direct myocardial revascularization laser system. METHODS:Regional wall motion in 10 patients undergoing catheter-based direct myocardial revascularization using a holmium:yttrium aluminium garnet laser was asses...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200006000-00010
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:Fetuin-A is a circulating glycoprotein that is involved in various stages of atherosclerosis. Despite the fact that emerging evidence suggests fetuin-A acts as a calcification inhibitor that protects against advanced calcified atherosclerosis in dialyzed patients, the role of fetuin-A in cardiovascular diseas...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e32832fe5d5
更新日期:2010-08-01 00:00:00
abstract:UNLABELLED:Plasma soluble adhesion molecules, intercellular adhesion molecule-1 (ICAM)-1, vascular cell adhesion molecule-1 (VCAM-1) and E-selectin leves of patients with isolated coronary artery ectasia (CAE), patients with obstructive coronary artery disease without CAE and subjects with angiographically normal coron...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200502000-00009
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:This study aimed at evaluating efficacy and safety of thrombus aspiration and intracoronary-targeted thrombolysis on coronary thrombus burden in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous catheterization, comparing their effects on myocardial perfusion through index of...
journal_title:Coronary artery disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/MCA.0000000000000743
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:We examined the effects of rosuvastatin treatment on triglyceride levels and lipid measures in a parallel-group multicenter trial (4522IL/0035) in patients with hypertriglyceridemia (Fredrickson Type IIb or IV). METHODS:After a 6-week dietary lead-in period while on a National Cholesterol Education Program ...
journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00019501-200403000-00008
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVES:Although the relationship between atherosclerosis and inflammatory cells has been recognized in recent years, the effect of interleukin-6 (IL-6) genetic variants associated with atherosclerosis is still controversial. Therefore, we investigated the association between IL-6 polymorphism and levels of IL-6 in ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e3282f27bf7
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The cause for discrepancy in the clinical presentation and outcome of coronary artery disease (CAD) between men and women is not established. Different prevalences of risk factors or specific sex-related atherosclerotic aspects have been advocated as possible explanations. We investigated coronary plaque mor...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000522
更新日期:2017-09-01 00:00:00
abstract::The Editor and Associate Editors are pleased that our readership will have the opportunity to benefit from a series of contributions by Dr John Rutherford addressing current issues in pharmacology and therapeutics pertinent to coronary artery disease. We are pleased also that Dr Rutherford will provide authoritative p...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200012000-00008
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Serum gamma-glutamyl transferase (GGT) activity, an enzyme responsible for the extracellular catabolism of antioxidant glutathione, may directly take part in atherogenesis and evolve as a potential biochemical risk indicator of cardiovascular morbidity and mortality. An important characteristic of coronary a...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e32830eaba1
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:The effects of initial tests on long-term events have been unknown. PATIENTS AND METHODS:In this observational retrospective study, we analyzed the effects of initial noninvasive tests by myocardial perfusion imaging (MPI) and computed tomography angiography (CTA) on long-term major adverse cardiac events (...
journal_title:Coronary artery disease
pub_type: 杂志文章,多中心研究
doi:10.1097/MCA.0000000000000645
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:P-selectin, an adhesion molecule of the selectin family, is expressed on the surface of activated thrombocytes by thrombin. The aim of the present study was to assess the predictive value of P-selectin (estimated by flow cytometric assay) for acute cardiac events in acute coronary syndrome. METHODS:The stud...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199508000-00009
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:Predictors of 30-day mortality may differ from predictors of mortality at 1 year among 30-day survivors of ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We aimed to evaluate the predictors of 30-day and 1-year mortality in unselected patients with ST...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e32832e5c4c
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVES:Limited data exist about the prognostic significance of new-onset atrial fibrillation (AF) after contemporary primary percutaneous coronary intervention (pPCI). The objective of this study was to identify the incidence and predictors of new-onset AF and associated adverse 30-day outcomes in AF patients who u...
journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章
doi:10.1097/MCA.0b013e32834df552
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Elderly patients with ischaemic heart disease are often treated more conservatively and for longer than younger patients, but this strategy may result in subsequent invasive intervention of more advanced and higher risk coronary disease. METHODS:We performed a retrospective analysis of 109 patients aged > o...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199711000-00006
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Platelets have an important role in coronary thrombosis. METHODS:We studied 151 consecutive patients undergoing implantation of Palmaz-Schatz stents because of suboptimal results after coronary balloon angioplasty treated by intense anticoagulation. Surface exposure of the constitutively expressed glycoprot...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199703000-00001
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:The failure of reperfusion therapy in patients with ST-segment elevation myocardial infarction (STEMI) is more frequent than considered previously. AIM:To evaluate sex-related differences in long-term outcomes in patients with STEMI and incomplete infarct-related artery reperfusion after a primary percutane...
journal_title:Coronary artery disease
pub_type: 杂志文章,多中心研究
doi:10.1097/MCA.0000000000000703
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate the association of plasma osmolality with all-cause mortality in ST-segment elevation myocardial infarction (STEMI) patients treated with a primary percutaneous coronary intervention. METHODS:This study included 3748 patients (mean age 58.3±11.8 years, men 81%) with ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000426
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Different cardiovascular risk calculators and risk-based thresholds for initiating statin therapy are currently in use. Using coronary computed tomography angiography, we sought to compare the Pooled-Cohort Equation [atherosclerotic cardiovascular disease (ASCVD) score] with the Systematic COronary Risk Eval...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0000000000000398
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Previous studies have suggested an increased risk of myocardial infarction associated with physical exercise. Activated neutrophils may contribute to the triggering mechanisms. METHODS:Fifteen patients with stable angina pectoris underwent symptom-limited bicycle ergometry. In neutrophils obtained from seri...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the association of widowhood with the severity and extent of coronary artery disease (CAD), and whether it is modified by sex or socioeconomic status. PATIENTS AND METHODS:A total of 1068 patients undergoing coronary angiography at five centers in Saudi Arabia and the Uni...
journal_title:Coronary artery disease
pub_type: 杂志文章,多中心研究
doi:10.1097/MCA.0000000000000436
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:There is growing interest in the role of microbes in the pathogenesis of coronary atherosclerosis but most of the evidence has been seroepidemiologic. It would be useful to know more about the cytology and histology of coronary lesions containing clearly depicted microbes. OBJECTIVE:To define carefully the ...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-200103000-00005
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:This study was designed to evaluate whether differences between sexes exist in serum-lipoprotein (a) [Lp(a)] and arterial-wall-apolipoprotein (a) [Apo(a)] levels in patients with advanced coronary artery disease. METHODS:The concentrations of Lp(a) in serum and Apo(a) in aortic biopsies were studied in 76 m...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199504000-00013
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVES:This Perspective reviews the results of early and contemporary studies evaluating the safety and efficacy of coronary revascularization in patients with diabetes. It also addresses the implications of some of the data in the Bypass Angioplasty Revascularization Investigation in type 2 diabetes (BARI 2D) tria...
journal_title:Coronary artery disease
pub_type: 杂志文章,评审
doi:10.1097/MCA.0b013e3283383ebe
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Coronary heart disease is a major cause of morbidity and mortality in the elderly, a rapidly growing section of the population. Elderly patients have been excluded from most preventative risk factor trials. METHODS:We evaluated fluvastatin, a fully synthetic hydroxymethyl glutaryl coenzyme A reductase inhib...
journal_title:Coronary artery disease
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:Ga-NOTA-RGD PET is a newly developed molecular imaging for angiogenesis. In this study, Ga-NOTA-RGD PET was used to investigate imaging characteristics in a rat myocardial infarction (MI) model and to monitor the efficacy of an angiogenesis induction therapy. MATERIALS AND METHODS:Ga-NOTA-RGD PET was perform...
journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/MCA.0b013e3283608c32
更新日期:2013-06-01 00:00:00