49
Obstructive
CAD
(≥50% stenosis)
Evaluate adequacy of GDMT
Intensify GDMT and option to defer testing
(1)
No ischemia Mild ischemia
Moderate/
severe ischemia
GDMT according to SIHD guideline
High-risk CAD
†
or
frequent angina
Stress Testing:
‡
Stress CMR
Stress PET
Stress SPECT
Stress echocardiography
(1)
Exercise ECG
(2a)
NO
Test choice should be guided by local availability and expertise.
* Known CAD means prior MI, revascularization, known obstructive CAD, nonobstructive
CAD.
† High-risk CAD means le main stenosis ≥50%; or obstructive CAD with FFR-CT ≤0.80.
‡ Test choice guided by the patient's exercise capacity, resting electrocardiographic abnormalities.
§ Patients with prior CABG or stents >3.0 mm.
Follow-up Testing and Intensification of GDMT Guided by Initial Test Results and
Persistence / Worsening / Frequency of Symptoms and Shared Decision Making
