Should NICE guidelines be universally accepted for the evaluation of stable coronary disease? A debate

Harvey S. Hecht, Leslee Shaw, Y. S. Chandrashekhar, Jeroen J. Bax, Jagat Narula

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

The 2016 National Institute of Health and Care Excellence clinical guideline for the assessment and diagnosis of chest pain positions coronary computed tomography angiography as the first test for all stable chest pain patients without confirmed coronary artery disease and discards the previous emphasis on calculation of pre-test likelihood recommended in their 2012 edition of the guidelines. On the other hand, the American College of Cardiology Foundation/American Heart Association and the European Society of Cardiology guidelines continue to present the stress testing functional modalities as the tests of choice. The aim of this review is to present, in the form of a debate, the pros and cons of these paradigm changing recommendations, with an emphasis on literature review and projection of future needs, with conclusions to be drawn by the reader.

Original languageEnglish
Pages (from-to)1440-1453
Number of pages14
JournalEuropean Heart Journal
Volume40
Issue number18
DOIs
StatePublished - 1 May 2019

Keywords

  • CTA
  • Functional testing
  • NICE

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