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Chronic Coronary Disease 2023

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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)

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