New Algorithm for the Prediction of Cardiovascular Risk in Symptomatic Adults with Stable Chest Pain

  • Muralidhar R. Papireddy
  • Carl J. Lavie
  • Abhizith Deoker
  • Hadii Mamudu
  • Timir K. Paul
Ischemic Heart Disease (D Mukherjee, Section Editor)
  • 64 Downloads
Part of the following topical collections:
  1. Topical Collection on Ischemic Heart Disease

Abstract

Purpose of Review

To review the landmark studies in predicting obstructive coronary artery disease (CAD) in symptomatic patients with stable chest pain and identify better prediction tools and propose a simplified algorithm to guide the health care providers in identifying low risk patients to defer further testing.

Recent Findings

There are a few risk prediction models described for stable chest pain patients including Diamond-Forrester (DF), Duke Clinical Score (DCS), CAD Consortium Basic, Clinical, and Extended models. The CAD Consortium models demonstrated that DF and DCS models overestimate the probability of CAD. All CAD Consortium models performed well in the contemporary population. PROMISE trial secondary data results showed that a clinical tool using readily available ten very low-risk pre-test variables could discriminate low-risk patients to defer further testing safely.

Summary

In the contemporary population, CAD Consortium Basic or Clinical model could be used with more confidence. Our proposed simple algorithm would guide the physicians in selecting low risk patients who can be managed conservatively with deferred testing strategy. Future research is needed to validate our proposed algorithm to identify the low-risk patients with stable chest pain for whom further testing may not be warranted.

Keywords

Algorithms Cardiovascular risk Stable chest pain Pre-test probability Coronary artery disease 

Notes

Compliance with Ethical Standards

Conflict of Interest

Muralidhar R. Papireddy, Carl J. Lavie, Abhizith Deoker, Hadii Mamudu, and Timir K. Paul declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Muralidhar R. Papireddy
    • 1
  • Carl J. Lavie
    • 2
  • Abhizith Deoker
    • 3
  • Hadii Mamudu
    • 4
  • Timir K. Paul
    • 1
  1. 1.Division of Cardiology, Department of Internal Medicine, Quillen College of MedicineEast Tennessee State UniversityJohnson CityUSA
  2. 2.Department of Cardiology, Ochsner Clinical SchoolThe University of Queensland School of MedicineNew OrleansUSA
  3. 3.Division of Cardiology, Department of Internal MedicineTexas Tech UniversityEl PasoUSA
  4. 4.Department of Health Services Management and Policy, College of Public HealthEast Tennessee State UniversityJohnson CityUSA

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