The performance of non-invasive tests to rule-in and rule-out significant coronary artery stenosis in patients with stable angina: a meta-analysis focused on post-test disease probability
Why the study?
Do non-invasive tests accurately rule-in and rule-out significant coronary artery stenosis in patients with stable angina?
Population
Patients with stable angina
Design
Meta-analysis
Authors
Discussion
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Member takes
Implication
Tailor non-invasive CAD testing to pre-test probability in stable angina; confirms stress ECG's limited power and refines modality selection.
Key Points
- Evaluate the clinical performance of non-invasive diagnostic tests to rule in and rule out significant coronary artery disease in patients presenting with stable angina.
- Conducted a meta-analysis evaluating the diagnostic accuracy of non-invasive modalities for anatomically and functionally significant coronary artery disease.
- Assessed diagnostic performance relative to post-test disease probability ranges and specific reference standards.
- Different non-invasive modalities showed distinct optimal performance ranges for identifying anatomically and functionally significant coronary artery stenosis.
- Stress electrocardiography (ECG) demonstrated very limited diagnostic power to either rule in or rule out coronary artery disease.
Structured PICO
Do non-invasive tests accurately rule-in and rule-out significant coronary artery stenosis in patients with stable angina?
P
Population
Patients with stable angina
I
Intervention
Non-invasive diagnostic tests (including stress ECG)
O
Outcome
Detection of anatomically and functionally significant coronary artery disease (CAD) to rule-in and rule-out significant coronary artery stenosissurrogate
The selection of non-invasive diagnostic tests for stable angina should be tailored to the patient's pre-test probability, recognizing the limited diagnostic power of stress ECG.
Cite This Study
Knuuti et al. (2018) studied this question.