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Table 9 Recommendations for CMR in the context of myocardial revascularization

From: Role of cardiovascular magnetic resonance in the guidelines of the European Society of Cardiology

Recommendations for imaging to determine ischemia to plan revascularization Classa Levelb Page
 Stress CMR, stress-echo, SPECT or PET are recommended in subjects with intermediate pretest probability for suspected coronary artery disease and stable symptoms I A 14
 To achieve a prognostic benefit by revascularization in patients with coronary artery disease, ischemia has to be documented by non-invasive imaging    
 Left main disease with stenosis >50 % I A 18
 Any proximal LAD stenosis >50 % I A 18
 Two-vessel or three-vessel disease with stenosis > 50 % with impaired LV function (LVEF < 40 %)a I A 18
 Large area of ischaemia (>10 % LV) I B 18
 Single remaining patent coronary artery with stenosis >50 % I C 18
Recommendations for follow-up and management after myocardial revascularization for asymptomatic patients Classa Levelb Page
 Early imaging testing should be considered in specific patient subsets. IIa C 72
 Routine stress testing may be considered >2 years after PCI and >5 years after CABG. IIa B 72
Recommendations for follow-up and management after myocardial revascularization for symptomatic patients Classa Levelb Page
 It is recommended to reinforce medical therapy and lifestyle changes in patients with low-risk findings at stress testing. I C 72
 With intermediate- to high-risk findings at stress testing, coronary angiography is recommended. I C 72
Recommendation for carotid artery screening before CABG Classa Levelb Page
 CMR, CT, or digital subtraction angiography may be considered if carotid artery stenosis by ultrasound is >70 % and myocardial revascularization is contemplated. IIb C 39
  1. a Class of recommendation
  2. b Level of evidence