Summary Table 1. Detection of CAD in Symptomatic Patients with No Previous History of CAD.
| Appropriateness Criteria (Median Score) | Level of Evidence | Key References | |||
|---|---|---|---|---|---|
| Non-Acute Chest Pain Patients Suspected of Ischemic Chest Pain | |||||
| 1 | Interpretable ECG and capable of exercise | Low | U (5) | A | (11, 13) |
| Intermediate | A (7) | A | (11, 13) | ||
| High | I (3) | B | (16) | ||
| 2 | Uninterpretable ECG or unable to exercise | Low | A (7) | A | (11, 13) |
| Intermediate | A (8) | A | (11, 13) | ||
| High | U (5) | B | (16) | ||
| Acute Chest Pain Patients Suspected of ACS | |||||
| 3 | Definite myocardial infarction (MI) | I (1) | C | NA | |
| 4 | Persistent ECG ST-segment elevation following exclusion of MI | U (6) | B | (18) | |
| 5 | Acute chest pain of uncertain causes (pulmonary embolism, aortic dissection, and ACS ["triple rule out"]) | A (7) | B | (25, 31) | |
| 6 | Normal ECG and cardiac biomarkers | Low | A (7) | A | (18, 22, 23) |
| Intermediate | A (7) | A | (18, 22, 23) | ||
| High | A (7) | A | (18, 22) | ||
| 7 | Uninterpretable ECG | Low | A (7) | A | (18, 21, 23) |
| Intermediate | A (7) | A | (18, 21, 23) | ||
| High | U (5) | B | (18) | ||
| 8 | Nondiagnostic ECG or equivocal cardiac biomarkers | Low | A (7) | A | (18, 23) |
| Intermediate | A (7) | A | (18, 23) | ||
| High | U (5) | B | (18) | ||