Coronary artery disease

Overestimation of CAD among patients with chest pain

Recent studies have shown that as few as 6-10% of patients referred to non-invasive testing suffer from significant coronary artery disease (CAD).1,2,3

Chest pain can be mistaken for CAD but is also a symptom related to muscle pain, stomach conditions and psychological stress. Healthcare professionals need an efficient, reliable and easy-to-use rule-out support to detect significant CAD. Currently available methods can sometimes be time-consuming, costly and include invasive examination, exposing the patient to stress and anxiety. 

Diagnosing coronary artery disease

Vague symptoms like chest pain or shortness of breath could be related to coronary artery disease. However, some patients do not experience any classic symptoms or have symptoms that are extraordinary. Safe, efficient assessment of individuals with chest pain and suspected stable angina is challenging. In the process of accurately diagnosing stable CAD, general practitioners and cardiologists must balance the risk of falsely classifying a patient with chest pain and existing CAD as “low risk”, against the risk of exposing healthy individuals to non-invasive or invasive diagnostic procedures.

Less than 10% of the investigated patients suffer from CAD
Commonly used risk stratification strategies like the Diamond Forrester score (DS) for patients with chest pain and suspected stable coronary artery disease are known to overestimate the likelihood of the disease. Studies have shown that 9 out of 10 patients referred to non-invasive diagnostic procedures do not suffer from significant CAD. Regarding invasive examination, two-thirds of the patients undergoing elective diagnostic angiograms do not have significant CAD.4 These risk stratification strategies are likely to expose patients to costly investigations with higher risks, long waiting times and unnecessary stress.

New methods for diagnosing CAD

In summary, a large proportion of patients evaluated with invasive diagnostics do not suffer from significant CAD. There is a clear need to improve the selection of patients with chest pain for further cost-intensive cardiac diagnostic procedures. This can be achieved through better identification and early rule-out of patients not suffering from significant coronary artery disease.5 The CADScor®System is an innovative, ultrasensitive analytical device designed to support a safe, reliable and cost-efficient rule-out of significant CAD at the very first stage of the diagnostic pathway.

 

References
1. Therming, C. et al. Low Diagnostic Yield of Non-Invasive Testing in Patients with Suspected Coronary Artery Disease: Results From a Large Unselected Hospital-Based Sample. Eur Heart J – Qual Care Clin Outcomes 2018: 4, 301-308
2. Winther, S. et al. Diagnostic performance of an acoustic-based system for coronary artery disease risk stratification. Heart 2018: 104, 928-935
3. Douglas, PS et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med 2015: 372, 1291-1300
4. Patel, MR. et al. (2010) Low diagnostic yield of elective coronary angiography. N. Engl. J. Med. 362, 886–895
5. Prof. Dr. Med Albus, C et al. (2017) The Diagnosis of Chronic Coronary Heart Disease. Dtsch Arztebl Int. 114 (42):712-719

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