11
Table 5. Potential Features Associated With a Higher Risk of
MACE Among Patients With Established CCD
SPECT or PET: Percentage fixed myocardium on SPECT, transient ischemic dilation
with stress, reduced coronary flow reserve, ischemic electrocardiographic changes with
stress
Higher calcium score: alone and in addition to functional imaging
CCTA: total plaque burden, high-risk plaque (positive remodeling [remodeling index
>1.1], low attenuation [mean CT number <30 HU], or napkin-ring sign), reduced
CT-fractional flow reserve
CMR: reduced le and/or right ventricular ejection fraction, le ventricular
hypertrophy, scar or infarct, reduced myocardial perfusion reserve, myocardial blood
flow at stress
Biomarkers
High-sensitivity troponin, B-type natriuretic peptide
Treatment
4.1. General Approach to Treatment Decisions
COR LOE
Recommendations
1 C-LD 1. In patients with CCD, clinical follow-up at least annually is
recommended to assess for symptoms, change in functional
status, adherence to and adequacy of lifestyle and medical
interventions, and monitoring for complications of CCD and
its treatments.
2b B-NR 2. In patients with CCD, use of a validated CCD-specific
patient-reported health status measure may be reasonable to
assess symptoms, functional status, and QOL.
4. Treatment
(cont'd)
