Risk Stratification of Patients With Chest Pain and High-Risk Plaque Original Investigation Research Invited Commentary High-Risk Coronary Atherosclerotic Plaque Assessment by Coronary Computed Tomography Angiography— Should We Use It? Raymond J. Gibbons, MD Coronary computed tomography angiography (CTA) has an tions and correctly includes stroke as an end point. The increasing role in the diagnostic and prognostic assessment of PROMISE trial included symptomatic patients with SIHD; patients with stable ischemic heart disease (SIHD). The stroke was not an end point. A more inclusive analysis would PROMISE trial has tested the have relied on historical variables of symptomatic patients, hypothesis that coronary CTA which would have included eliciting histories of peripheral vas- Related article page 144 anatomic assessment of pa- cular disease, cerebrovascular disease, and more details re- tients with SIHD would re- garding symptoms (eg, the presence of chest pain, dyspnea, duce cardiac events compared with conventional stress test- and typical angina, or not). These important variables are in- ing, but it has not found an advantage for a coronary CTA cluded in the Supplement of the study by Ferencik et al, but strategy. it is not clear whether they were ever considered in the analy- The PROMISE (Prospective
JAMA Cardiology – American Medical Association
Published: Feb 10, 2018
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