Prognostic Value of Noninvasive Cardiovascular Testing in Patients with Stable Chest Pain: Insights from the PROMISE Trial
This recent paper in Circulation, Prognostic Value of Noninvasive Cardiovascular Testing in Patients w/ Stable Chest Pain: Insights from PROMISE Trial, highlights results from PROMISE trial. The paper demonstrates that coronary CTA, by identifying patients at risk due to nonobstructive CAD, provides better prognostic information than functional testing in contemporary stable chest pain patients with a low burden of obstructive CAD, myocardial ischemia, and events.
"Our work provides generalizable data for one of the fundamental elements of cardiology patient care establishing that hallmarks of traditional stable chest pain assessment such as obstructive CAD and myocardial ischemia have comparable prognostic value'" says lead author Udo Hoffmann, MD. "However, as other studies have shown, statins and improved cardiovascular risk management have lowered the clinical event risk of these patients as compared to 30 years ago. In this changed situation, we clearly show the benefit of CTA being able to detect subclinical atherosclerotic disease, i.e. non-obstructive CAD to identify an additional at risk population, in which a large proportion of future clinical events occur. I believe these data will enable caregivers to make an objective data driven choice as to which diagnostic test may be most beneficial for a patient presenting with stable chest pain."
Authors: Udo Hoffmann, Maros Ferencik, James E. Udelson, Michael H. Picard, Quynh A. Truong, Manesh R. Patel, Megan Huang, Michael J. Pencina, Daniel B. Mark, John F. Heitner, Christopher B. Fordyce, Patricia A. Pellikka, Jean-Claude Tardif, Matthew J. Budoff, George Nahhas, Benjamin J. Chow, Andrzej S. Kosinski, Kerry L. Lee, Pamela S. Douglas
and on behalf of the PROMISE Investigators
Originally published April 7, 2017