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• W1844178906 abstract "Evaluation of patients with symptoms suggestive of myocardial ischemia is one of the most frequent problems in clinical cardiology. As such, it is associated with large and growing costs. All the same, until recently, there was a complete lack of randomized trial data to guide testing choice. Today, only testing for ischemia has a class IA recommendation 1 Fihn S.D. Gardin J.M. Abrams J. et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients with Stable Ischemic Heart Disease: Executive Summary. JACC. 2012; 60: 2564-2603 Abstract Full Text Full Text PDF Scopus (183) Google Scholar and is performed in 90% of patients who are evaluated for the presence of coronary artery disease. 2 Levin D.C. Parker L. Halpern E.J. Julsrud P.R. Rao V.M. The lack of growth in use of coronary CT angiography: is it being appropriately used?. AJR Am J Roentgenol. 2011; 196: 862-867 Crossref PubMed Scopus (11) Google Scholar However, functional testing appears to be a poor gatekeeper for invasive coronary angiography 3 Patel M.R. Peterson E.D. Dai D. et al. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010; 362: 886-895 Crossref PubMed Scopus (1130) Google Scholar with most patients that ultimately proceed to invasive catheterization not having obstructive coronary artery disease. Coronary CT angiography (CTA), an anatomic test, has excellent diagnostic accuracy for the direct noninvasive detection of coronary artery disease, both regarding stenoses 4 Janne d'Othee B. Siebert U. Cury R. Jadvar H. Dunn E.J. Hoffmann U. A systematic review on diagnostic accuracy of CT-based detection of significant coronary artery disease. Eur J Radiol. 2008; 65: 449-461 Abstract Full Text Full Text PDF PubMed Scopus (135) Google Scholar and nonobstructive plaque. This suggests that coronary CTA could provide good triage and excellent prognostic value. 5 van Werkhoven J.M. Schuijf J.D. Gaemperli O. et al. Prognostic value of multislice computed tomography and gated single-photon emission computed tomography in patients with suspected coronary artery disease. J Am Coll Cardiol. 2009; 53: 623-632 Abstract Full Text Full Text PDF PubMed Scopus (293) Google Scholar In many ways, this testing profile was what cardiologists had been hoping for a long time. Hence, the rationale for the PROMISE trial 6 Douglas P.S. Hoffmann U. Lee K.L. et al. PROspective Multicenter Imaging Study for Evaluation of chest pain: rationale and design of the PROMISE trial. Am Heart J. 2014; 167: 796-803.e1 Abstract Full Text Full Text PDF PubMed Scopus (93) Google Scholar was to provide randomized data that compare the effect of choosing a functional vs an anatomic approach on health outcomes, safety, cost, and management of patients with suspected obstructive coronary artery disease." @default.
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• W1844178906 title "The PROMISE trial: An inside perspective" @default.
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• W1844178906 doi "https://doi.org/10.1016/j.jcct.2015.05.002" @default.
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