{"id":1461,"date":"2010-03-11T11:27:11","date_gmt":"2010-03-11T16:27:11","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/low-diagnostic-yield-of-elective-coronary-angiography\/"},"modified":"2011-07-19T17:44:18","modified_gmt":"2011-07-19T21:44:18","slug":"low-diagnostic-yield-of-elective-coronary-angiography","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2010\/03\/11\/low-diagnostic-yield-of-elective-coronary-angiography\/","title":{"rendered":"Low Diagnostic Yield of Elective Coronary Angiography"},"content":{"rendered":"<p>According to a recent <a href=\"http:\/\/content.nejm.org\/cgi\/content\/abstract\/362\/10\/886\">study<\/a>, of almost 400,000 patients referred for elective coronary angiography, only 38% had obstructive CAD.\u00a0 Those with a positive noninvasive test before angiography were only moderately more likely to have obstructive CAD than those who did not undergo any testing (41% vs 35%, respectively).\u00a0 However, in <a href=\"http:\/\/cardioexchange.org\/jwatch\/cardiology\/content\/full\/2010\/310\/1\">a comment in Journal Watch<\/a>, Harlan Krumholz notes that the study\u2019s reporting of noninvasive testing is inadequate for assessing the implications of positive results. Furthermore, the presence of typical symptoms was a much better predictor of CAD than a positive noninvasive test (ORs, 1.91\u00a0and 1.28, respectively); still,\u00a030% of those referred for angiography had no anginal symptoms.<\/p>\n<p>More than 9 million myocardial perfusion imaging studies are performed annually in the U.S.\u00a0 How do we improve the quality of noninvasive testing?\u00a0 In the absence of planned transplantation or valvular surgery, should asymptomatic patients be referred for coronary angiography?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>According to a recent study, of almost 400,000 patients referred for elective coronary angiography, only 38% had obstructive CAD.\u00a0 Those with a positive noninvasive test before angiography were only moderately more likely to have obstructive CAD than those who did not undergo any testing (41% vs 35%, respectively).\u00a0 However, in a comment in Journal Watch, [&hellip;]<\/p>\n","protected":false},"author":214,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1461","post","type-post","status-publish","format-standard","hentry","category-general"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/1461","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/214"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=1461"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/1461\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=1461"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=1461"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=1461"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}