Why the study?
The 2019 ESC guidelines on Chronic Coronary Syndromes introduced a new risk assessment paradigm for pre-test probability, prompting re-evaluation of the CAD-score for CAD ruling-out.
Does the CAD-score improve risk reclassification for ruling out CAD compared to ESC 2019 clinical pre-test probability alone in patients with suspected CAD?
Does the CAD-score improve risk reclassification for ruling out CAD compared to ESC 2019 clinical pre-test probability alone in patients with suspected CAD?
Absolute Event Rate: 4.1% vs 3.4%
p-value: p=0.52
The acoustic-based CAD-score effectively reclassifies a significant proportion of patients with suspected CAD to a low-risk category (≤5% probability) under the ESC 2019 guidelines without exceeding the acceptable miss rate for significant CAD.
CAD-score may safely expand low-risk reclassification in suspected CAD; leaves open need for prospective validation before practice change.
In August 2019, ESC published new guidelines on Chronic Coronary Syndromes including a new risk assessment paradigm for estimation of pre-test-probability. The CAD-score is an acoustic-based score for ruling-out of coronary artery disease (CAD). In the current letter to the editor we re-evaluate the re-classification potential the CAD-score in the view of the new guidelines.
No takes yet. Share an insight, caveat, or question.
Schmidt et al. (2019) conducted a letter in Suspected coronary artery disease (n=1,671). CAD-score (acoustic-based score) vs. ESC 2019 guidelines pre-test probability alone was evaluated on Prevalence of significant coronary artery disease in the low likelihood group (p=0.52).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: