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5.2.1. Patients With Obstructive CAD Who Present With
Stable Chest Pain
COR LOE
Recommendations
Stress Testing
1 B-NR 5. For patients with obstructive CAD who have stable chest
pain despite optimal GDMT, stress PET/SPECT MPI,
CMR, or echocardiography is recommended for diagnosis of
myocardial ischemia, estimating risk of MACE, and guiding
therapeutic decision-making.
2a B-R 6. For patients with obstructive CAD who have stable chest pain
despite optimal GDMT, when selected for rest/stress nuclear
MPI, PET is reasonable in preference to SPECT, if available,
to improve diagnostic accuracy and decrease the rate of non-
diagnostic test results.
2a B-NR 7. For patients with obstructive CAD who have stable chest pain
despite GDMT, exercise treadmill testing can be useful to
determine if the symptoms are consistent with angina pectoris,
assess the severity of symptoms, evaluate functional capacity
and select management, including cardiac rehabilitation.
2a B-NR 8. For patients with obstructive CAD who have stable chest pain
symptoms undergoing stress PET MPI or stress CMR, the
addition of MBFR is useful to improve diagnosis accuracy and
enhance risk stratification.
(cont'd)
