43
5.1.3. Intermediate-High Risk Patients With Stable Chest
Pain and No Known CAD
COR LOE
Recommendations
Secondary Diagnostic Testing: What to Do If Index Test Results Are Positive or
Inconclusive
Sequential or Add-on Testing
2a B-NR 7. For intermediate-high risk patients with stable chest pain
and known coronary stenosis of 40% to 90% in a proximal or
middle coronary segment on CCTA, FFR-CT can be useful
for diagnosis of vessel-specific ischemia and to guide decision-
making regarding the use of coronary revascularization.
2a B-NR 8. For intermediate-high risk patients with stable chest pain after
an inconclusive or abnormal exercise ECG or stress imaging
study, CCTA is reasonable.
2a B-NR 9. For intermediate-high risk patients with stable chest pain and
no known CAD undergoing stress testing, the addition of
CAC testing can be useful.
2a B-NR 10. For intermediate-high risk patients with stable chest pain after
inconclusive CCTA, stress imaging is reasonable.
2b C-EO 11. For intermediate-high risk patients with stable chest pain after
a negative stress test but with high clinical suspicion of CAD,
CCTA or ICA may be reasonable.
(cont'd)