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Stable Ischemic Heart Disease

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21 Table 9. CAD Prognostic Index Extent of CAD Prognostic Weight (0-100) 5-Year Survival Rate (%) a 1-vessel disease, 75% 23 93 1-vessel disease, 50%-74% 23 93 1-vessel disease, ≥95% 32 91 2-vessel disease 37 88 2-vessel disease, both ≥95% 42 86 1-vessel disease, ≥95% proximal le anterior descending (LAD) artery 48 83 2-vessel disease, ≥95% LAD artery 48 83 2-vessel disease, ≥95% proximal LAD artery 56 79 3-vessel disease 56 79 3-vessel disease, ≥95% in ≥1 vessel 63 73 3-vessel disease, 75% proximal LAD artery 67 67 3-vessel disease, ≥95% proximal LAD artery 74 59 a Assuming medical treatment only. Invasive Testing for Diagnosis of Coronary Artery Disease in Patients With Suspected SIHD (New in 2014) Î Coronary angiography is useful in patients with presumed SIHD who have unacceptable ischemic symptoms despite guideline-directed medical therapy (GDMT) and who are amenable to, and candidates for, coronary revascularization. (I-C) Î Coronary angiography is reasonable to define the extent and severity of CAD in patients with suspected SIHD whose clinical characteristics and results of noninvasive testing (exclusive of stress testing) indicate a high likelihood of severe IHD and who are amenable to, and candidates for, coronary revascularization. (IIa-C) Î Coronary angiography is reasonable in patients with suspected symptomatic SIHD who cannot undergo diagnostic stress testing, or have indeterminate or nondiagnostic stress tests, when there is a high likelihood that the findings will result in important changes to therapy. (IIa-C) Î Coronary angiography might be considered in patients with stress test results of acceptable quality that do not suggest the presence of CAD when clinical suspicion of CAD remains high and there is a high likelihood that the findings will result in important changes to therapy. (IIb-C)

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