Assessment of Pre-test and Clinical Probability in the Diagnosis of Chronic Coronary Syndrome — What's New?
In the 2019 European Society of Cardiology (ESC) guidelines, the diagnostic algorithm for chronic coronary syndrome (CCS) was significantly changed, a significant revision of the pretest probability assessment scale (PTP) was made, an assessment of the clinical probability of obstructive coronary ar...
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| Format: | Article |
| Language: | English |
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Столичная издательская компания
2022-03-01
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| Series: | Рациональная фармакотерапия в кардиологии |
| Subjects: | |
| Online Access: | https://www.rpcardio.online/jour/article/view/2665 |
| _version_ | 1797232049343430656 |
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| author | A. N. Sumin A. V. Shcheglova |
| author_facet | A. N. Sumin A. V. Shcheglova |
| author_sort | A. N. Sumin |
| collection | DOAJ |
| description | In the 2019 European Society of Cardiology (ESC) guidelines, the diagnostic algorithm for chronic coronary syndrome (CCS) was significantly changed, a significant revision of the pretest probability assessment scale (PTP) was made, an assessment of the clinical probability of obstructive coronary artery disease was proposed, the recommendations on the use of diagnostic tests in various groups of patients were updated. Such a radical change in approaches to the diagnosis of CCS raised many questions that had to be answered by further studies conducted in the past two years. The review provides data on the validation of the new PTP scale and the proposed assessment of the clinical probability of obstructive coronary artery disease, taking into account risk factors and with the additional inclusion of information on the calcium index of coronary arteries. The proposals of experts on new algorithms for the choice of non-invasive / invasive examination of this category of patients were also considered. Overall, the new PTV rating scale (ECS 2019) has been validated and validated in retrospective analyzes of cohort studies. The scale for assessing the clinical likelihood of obstructive coronary artery disease makes it possible to classify 3.8-5 times more patients as a low probability of coronary artery disease compared to the assessment of PTP alone. Assessment of the post-test probability of coronary artery disease does not allow to confirm the presence of obstructive lesion and was not used. The experts proposed new modifications of the diagnostic algorithm (with a detailed assessment of the clinical probability, as well as without taking it into account), which require verification in further studies. Therefore, it is advisable to conduct prospective studies to confirm the possibility of reducing the total number of non-invasive and invasive studies in patients with suspected coronary heart disease, as well as the safety of such a decrease in diagnostic procedures. |
| first_indexed | 2024-03-08T14:00:29Z |
| format | Article |
| id | doaj.art-d09323f814644f9d8e64f14288096b32 |
| institution | Directory Open Access Journal |
| issn | 1819-6446 2225-3653 |
| language | English |
| last_indexed | 2024-04-24T15:54:06Z |
| publishDate | 2022-03-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj.art-d09323f814644f9d8e64f14288096b322024-04-01T07:43:42ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532022-03-01181929610.20996/1819-6446-2022-02-041982Assessment of Pre-test and Clinical Probability in the Diagnosis of Chronic Coronary Syndrome — What's New?A. N. Sumin0A. V. Shcheglova1Research Institute for Complex Issues of Cardiovascular DiseasesResearch Institute for Complex Issues of Cardiovascular DiseasesIn the 2019 European Society of Cardiology (ESC) guidelines, the diagnostic algorithm for chronic coronary syndrome (CCS) was significantly changed, a significant revision of the pretest probability assessment scale (PTP) was made, an assessment of the clinical probability of obstructive coronary artery disease was proposed, the recommendations on the use of diagnostic tests in various groups of patients were updated. Such a radical change in approaches to the diagnosis of CCS raised many questions that had to be answered by further studies conducted in the past two years. The review provides data on the validation of the new PTP scale and the proposed assessment of the clinical probability of obstructive coronary artery disease, taking into account risk factors and with the additional inclusion of information on the calcium index of coronary arteries. The proposals of experts on new algorithms for the choice of non-invasive / invasive examination of this category of patients were also considered. Overall, the new PTV rating scale (ECS 2019) has been validated and validated in retrospective analyzes of cohort studies. The scale for assessing the clinical likelihood of obstructive coronary artery disease makes it possible to classify 3.8-5 times more patients as a low probability of coronary artery disease compared to the assessment of PTP alone. Assessment of the post-test probability of coronary artery disease does not allow to confirm the presence of obstructive lesion and was not used. The experts proposed new modifications of the diagnostic algorithm (with a detailed assessment of the clinical probability, as well as without taking it into account), which require verification in further studies. Therefore, it is advisable to conduct prospective studies to confirm the possibility of reducing the total number of non-invasive and invasive studies in patients with suspected coronary heart disease, as well as the safety of such a decrease in diagnostic procedures.https://www.rpcardio.online/jour/article/view/2665chronic coronary syndromepre-test probabilityclinical probabilitydiagnostic algorithm |
| spellingShingle | A. N. Sumin A. V. Shcheglova Assessment of Pre-test and Clinical Probability in the Diagnosis of Chronic Coronary Syndrome — What's New? Рациональная фармакотерапия в кардиологии chronic coronary syndrome pre-test probability clinical probability diagnostic algorithm |
| title | Assessment of Pre-test and Clinical Probability in the Diagnosis of Chronic Coronary Syndrome — What's New? |
| title_full | Assessment of Pre-test and Clinical Probability in the Diagnosis of Chronic Coronary Syndrome — What's New? |
| title_fullStr | Assessment of Pre-test and Clinical Probability in the Diagnosis of Chronic Coronary Syndrome — What's New? |
| title_full_unstemmed | Assessment of Pre-test and Clinical Probability in the Diagnosis of Chronic Coronary Syndrome — What's New? |
| title_short | Assessment of Pre-test and Clinical Probability in the Diagnosis of Chronic Coronary Syndrome — What's New? |
| title_sort | assessment of pre test and clinical probability in the diagnosis of chronic coronary syndrome what s new |
| topic | chronic coronary syndrome pre-test probability clinical probability diagnostic algorithm |
| url | https://www.rpcardio.online/jour/article/view/2665 |
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