An Integrated Clinical Classification for Ischemic Heart Disease: A Combined Assessment of Severity of Coronary Disease, Left Ventricular Function and Myocardial Ischemia

Abstract

The traditional clinical classifications of patients with coronary heart disease have utilized either a descriptive categorization of the extent of coronary artery disease, ie. single, double or triple vessel disease, or have relied on a description of the associated pattern of symptoms of angina pectoris. Although numerous studies have demonstrated the importance of the extent of disease and symptomatology in diagnosis and management (1–5), it is becoming increasingly clear that symptoms of angina may be poorly correlated with prognosis as angina may be an insensitive marker of the activity of ischemic heart disease (6–10). It is therefore important that the descriptive clinical classifications be revised by integrating the three major components influencing prognosis and management including coronary anatomy, left ventricular function, and the presence and extent of myocardial ischemia.