Article Impact Level: HIGH Data Quality: STRONG Summary of European Heart Journal, 44(2), 142–158. https://doi.org/10.1093/eurheartj/ehac640 Dr. Danilo Neglia et al
Points
- In this assessment of the potential multi-center EURECA Imaging registry incorporating 5156 chronic coronary syndrome patients selected between May 2019 and March 2020, it was found that 44% of the patients did not follow the guidelines of the European Society of Cardiology for the utilization of imaging tests in chronic coronary syndromes. Following the recommendations was linked to improved living standards, fewer repeat tests, more excellent rates of obstructive coronary artery disease diagnosis and treatment, and lower rates of invasive coronary angiography.
- These findings illustrate how frequently individuals with chronic coronary syndromes do not follow current recommendations regarding the utilization of imaging tests and demonstrate that following standards were linked to better diagnostic results and fewer procedures.
- The European Society of Cardiology member countries’ rising and inconsistent use of invasive procedures and cardiac imaging in patients with chronic coronary syndromes has highlighted the need for standardization and raised questions about potential disparities in resource availability and access between nations.
Summary
Five thousand one hundred fifty-six (5,156) participants from 24 different ESC member countries were enrolled in 73 centers between May 2019 and March 2020. The implementation of medical guidelines was assessed using clinical presentation and pre-test probability of severe coronary artery disease.
The median age of participants was 64, and more than half of them were men. 42% had a pre-test probability above 15%, 27% had coronary artery disease, and 5% had ejection fractions below 50%. Exercise electrocardiography was done on 32% of patients, stress imaging was chosen in 40% of cases, and computed tomography coronary angiography was done in 22% of cases. 24% of the patients had obstructive coronary artery disease, 19% had inducible ischemia, and 13% had revascularization. The diagnostic procedure did not use the guidelines in 44% of individuals.
The 2019 European Society of Cardiology recommendations applied to all participants with chronic coronary syndromes who were registered in the EURECA database and were treated generally. Implementation of guidelines resulted in decreased percentages of coronary revascularizations and invasive coronary angiograms. But when the European Society of Cardiology guidelines carried out invasive angiograms, 60% of patients appeared to have obstructive coronary artery disease, and 54% required revascularization, as opposed to 39% and 37%, respectively, when the testing methodology did not follow the European recommendations.
Guidelines on screening procedures are not widely adopted in contemporary clinical practice for patients with chronic coronary syndrome. Surgical procedures are employed less often, and the diagnostic output and medical usefulness are better when the diagnostic method incorporates proper guidelines.
Link to the article: https://academic.oup.com/eurheartj/article/44/2/142/6855562
References Neglia, D., Liga, R., Gimelli, A., Podlesnikar, T., Cvijić, M., Pontone, G., Miglioranza, M. H., Guaricci, A. I., Seitun, S., Clemente, A., Sumin, A., Vitola, J., Saraste, A., Paunonen, C., Sia, C.-H., Paleev, F., Sade, L. E., Zamorano, J. L., Maroz-Vadalazhskaya, N., … Yilmaz, S. (2023). Use of cardiac imaging in chronic coronary syndromes: The EURECA Imaging registry. European Heart Journal, 44(2), 142–158. https://doi.org/10.1093/eurheartj/ehac640
