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Table 2.2 Asymptomatic Patients With Prior Revascularization or MI

From: ACC/AHA/ASE/ASNC/ASPC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2023 Multimodality Appropriate Use Criteria for the Detection and Risk Assessment of Chronic Coronary Disease

Clinical Scenario Text

ECG Treadmill

Stress Nuclear MPI

Stress Echo

Stress CMR

CAC

CCTA

Cath

No Test

39.

Incomplete revascularization

M (5)

M (6)

M (6)

M (6)

R (1)

M (4)

R (2)

M (5)

40.

Prior high-risk PCI

M (4)

M (6)

M (5)

M (5)

R (1)

M (4)

R (3)

M (5)

41.

< 5 y after CABG

R (2)

R (2)

R (2)

R (2)

R (1)

R (3)

R (1)

A (7)

42.

> 5 y after CABG

M (4)

M (4)

M (4)

M (4)

R (1)

M (4)

R (2)

A (7)

43.

< 2 y after PCI

R (2)

R (2)

R (2)

R (2)

R (1)

R (2)

R (1)

A (7)

44.

> 2 y after PCI

M (5)

M (5)

M (5)

M (5)

R (1)

M (4)

R (1)

A (7)

45.

Patients at high risk for or with a history of silent ischemia*

M (4)

A (7)

A (7)

A (7)

R (1)

M (5)

R (3)

M (5)

46.

Assessment of myocardial viability

R (1)

A (7)

M (6)

A (7)

R (1)

R (1)

R (1)

 

47.

Isolated evaluation of bypass graft patency

R (3)

M (5)

M (5)

M (5)

R (1)

A (7)

R (3)

M (6)

  1. If grayed out, rating not applicable
  2. A = Appropriate; CABG = coronary artery bypass graft; CAC = coronary artery calcium score; cath = cardiac catheterization; CCTA = coronary computed tomography angiography; CMR = cardiac magnetic resonance; ECG = electrocardiogram; echo = echocardiography; M = May Be Appropriate; MI = myocardial infarction; MPI = myocardial perfusion imaging; PCI = percutaneous coronary intervention; R = Rarely Appropriate
  3. *Diabetes mellitus with accelerated progression of CAD, chronic kidney disease, peripheral artery disease, prior brachytherapy, in-stent restenosis, saphenous vein graft intervention [42]