Dr. Stephen Schroeder,
This was a session on a clinically relevant and also controversial topic with excellent presentations and a vivid discussion.
Calcium scoring Prof. Knuuti gave a review of the currently available data, as well as on the current recommendations and guidelines. Especially, in intermediate risk patients, a coronary calcium scan might be considered to furthermore estimate an individual’s risk. But only, if diagnostics is potentially followed by a therapy.
Nuclear imaging Prof. Zellweger gave an overview on nuclear imaging. He highlighted the difference of morphologic and functional imaging. Which must be considered not oppositional, but additive. Nuclear imaging might be useful in asymptomatic high risk patients, e.g. diabetics.
Computed tomography angiography Dr.Scholte started his presentation with the statement “There is non indication for CTA in asymptomatic patients”. According to the current recommendations, a CTA might be considered in symptomatic patients with intermediate pre-test probability of having a significant lesion. However, Dr. Scholte showed some clinical cases, e.g. after radiation because of M.Hodgkin, underlining that a CTA might be also useful in very selected cases.
Cardiac magnetic resonance Prof.Schwitter gave an overview of the potential of CMTR in asymptomatic patients, focusing not only on CAD, but also on HCM or ARVD. He showed a review of the relevant literature, especially also on the prognostic value of CMR to predict the probability of developing an acute myocardial infarction in the future. In the absence of any ischemia, the prognosis is excellent.
Concluding, this was, all in all, an excellent session, not resolving all the open issues in this context, but giving a very good overview on the potential of the different techniques. The most important point, apart from the accurate patient selection, remains of course the appropriate expertise when using these modalities.
Risk assessment in the asymptomatic patient
Our mission: To reduce the burden of cardiovascular disease
© 2017 European Society of Cardiology. All rights reserved