45
Continue
preventive
therapies
(1)
Optimize preventive therapies
(1)
Optimize
preventive
therapies
(1)
Persistent symptoms?
Moderate–severe ischemia
Mild ischemia
Inconclusive
CAC (2a)
CCTA
(2a)
Invasive coronary
angiography
(1)
YES
Invasive coronary
angiography
(1)
NO
High-risk CAD
†
or
frequent angina
Test choice should be guided by local availability and expertise.
* Test choice guided by patient's exercise capacity, resting electrocardiographic abnormalities;
CCTA preferable in those <65 years of age and not on optimal preventive therapies; stress
testing favored in those ≥65 years of age (with a higher likelihood of ischemia).
† High-risk CAD means le main stenosis ≥ 50%; anatomically significant 3-vessel disease
(≥70% stenosis).
