Abstract
Cardiovascular disease remains the leading cause of death among Europeans, Americans, and around the world. In addition, the prevalence of coronary artery disease (CAD) is increasing, with the highest number of hospital visits, hospital readmissions for patients with decompensated heart failure, and a high economic cost. It is, therefore, a priority to try to plan the follow-up of patients with stable chronic CAD (scCAD) in relation to the published data, experience, and new technology that we have today. Planning the follow-up of patients with scCAD goes beyond the information provided by clinical management guidelines. It requires understanding the importance of a cross-sectional and longitudinal analysis in the clinical history of scCAD, because it has an impact on the cost of healthcare in relation to mortality, economic factors, and the burden of medical consultations. Using the data provided in this work facilitates and standardizes the clinical follow-up of patients with scCAD, and following the marked line makes the work for the clinical physician much easier, by including most clinical possibilities and actions to consider. The follow-up intervals vary according to the clinical situation of each patient and can be highly variable. In addition, the ability to properly study patients with imaging techniques, to stratify at different levels of risk, helps plan the intervals during follow-up. Given the complexity of coronary artery disease and the diversity of clinical cases, more studies are required in the future focused on improving the planning of follow-up for patients with scCAD. The perspective and future direction are related to the valuable utility of integrated imaging techniques in clinical follow-up.
Highlights
The number of patients with coronary artery disease (CAD) has increased
The Vall d’Hebron Risk Score (VH-RS) method has several useful features: it focuses on patients with different clinical variables, who underwent exercise tests, and myocardial perfusion gated SPECT images, and it assesses an individual’s cardiac risk for non-fatal myocardial infarction (MI), coronary revascularization (CR), and/or cardiac death in patients with established
Planning the follow-up of patients with stable chronic CAD (scCAD) goes beyond the information provided by clinical management guidelines
Summary
The number of patients with coronary artery disease (CAD) has increased. An estimated 15.5 million American adults have chronic CAD, and more than 7 million have angina [1,2]. Planning the follow-up of patients with stable chronic CAD (scCAD) from a clinical and cardiac imaging point of view is a complex issue that is usually poorly developed in the current literature. Require this cross-sectional sessment, not all patients have in the clinical practice setting need to be the evaluated for all these. If we consider annualcardiac cardiac check-up (Cch-up), as usual, the average number of Cch-ups during 10 years of follow-up is approximately 10 In this figure, many variables that can affect or determine the number of Cch-ups and/or the time intervals between Cch-ups are observed. Diagnostics 2021, 11, 1762 number of Cch-ups during 10 years of follow-up is approximately 10 CSA, cross-sectional assessment; LR, low risk, MR, moderate risk; HR, high risk
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