9
3.2. Risk Stratification and Relationship to Treatment
Selection
COR LOE
Recommendations
Risk Stratification and Prognosis
1 B-NR 1. In patients with CCD, it is recommended that risk
stratification incorporate all available information, including
noninvasive, invasive, or both cardiovascular diagnostic testing
results or use validated risk scores to classify patients as low
(<1%), intermediate (1%-3%), or high (>3%) yearly risk for
cardiovascular death or nonfatal MI.
Relationship to Treatment
1 A 2. In patients with CCD, optimization of GDMT is
recommended to reduce MACE.*
1 A 3. In patients with CCD with newly reduced LV systolic
function, clinical heart failure, or both, ICA is recommended
to assess coronary anatomy and guide potential
revascularization.
3: No
benefit
A 4. In patients with CCD, ICA for risk stratification is not
routinely recommended in patients without LV systolic
dysfunction, heart failure, stable chest pain refractory to
GDMT, and/or noninvasive testing suggestive of significant
(>50%) left main disease.
* Modified from the 2021 AHA/ACC/Multisociety guideline for the evaluation and
diagnosis of chest pain. Gulati M, et al. op. cit.
