Author + information
- Received July 18, 2016
- Revision received October 24, 2016
- Accepted October 25, 2016
- Published online March 6, 2017.
- Leslee J. Shaw, PhDa,∗ (, )
- Lawrence M. Phillips, MDb,
- Eike Nagel, MDc,
- David E. Newby, MDd,
- Jagat Narula, MD, PhDe and
- Pamela S. Douglas, MDf
- aEmory University School of Medicine, Atlanta, Georgia
- bNew York University Langone Medical Center, New York City, New York
- cInstitute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Frankfurt am Main, Germany
- dUniversity of Edinburgh, Edinburgh, Scotland
- eMount Sinai School of Medicine, New York City, New York
- fDuke Clinical Research Institute, Durham, North Carolina
- ↵∗Address for correspondence:
Dr. Leslee J. Shaw, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, 1462 Clifton Road NE, Room 529, Atlanta, Georgia 30342.
The evaluation of patients with suspected stable ischemic heart disease is among the most common diagnostic evaluations with nearly 20 million imaging and exercise stress tests performed annually in the United States. Over the past decade, there has been an evolution in imaging research with an ever-increasing focus on larger registries and randomized trials comparing the effectiveness of varying diagnostic algorithms. The current review highlights recent randomized trial evidence with a particular focus comparing the effectiveness of cardiac imaging procedures within the stable ischemic heart disease evaluation for coronary artery disease detection, angina, and other quality of life measures, and major clinical outcomes. Also highlighted are secondary analyses from these trials on the economic findings related to comparative cost differences across diagnostic testing strategies.
Dr. Shaw is the Principal Investigator (PI) for the WOMEN trial; is past president of the American Society of Nuclear Cardiology; and is current president of the Society of Cardiovascular Computed Tomography. Dr. Nagel is the PI for the MR-INFORM trial; is a past president of the Society of Cardiovascular Magnetic Resonance; has received research support from Bayer Healthcare, Philips Healthcare, Siemens Healthcare, and Tom Tec; has received research and educational support from Medis; and has received speaker honoraria from Bayer Healthcare and Siemens Healthcare. Dr. Newby is the PI for the SCOT-HEART trial; has consulted for Toshiba; and has collaborated with Guerbet. Dr. Douglas is the PI for the PROMISE trial; and is past president of the American Society of Echocardiography and American College of Cardiology. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Daniel Berman, MD, served as the Guest Editor for this paper.
- Received July 18, 2016.
- Revision received October 24, 2016.
- Accepted October 25, 2016.
- American College of Cardiology Foundation
- Graphical abstract
- Imaging-Directed Strategies to Improve Patient Outcomes
- Imaging Trial Designs
- Trial Eligibility: Patient Selection Challenges
- Trial Endpoints
- Current Randomized Trials in SIHD
- Comparative Effectiveness for Major Clinical Endpoints
- Comparative Effectiveness for Angina and Other Health Status Endpoints
- Comparative Effectiveness for Diagnostic Endpoints
- Comparative Costs for Diagnostic Test Strategies
- Ongoing RCTs
- Knowledge Gaps and RCT Limitations
- Health Policy Implications of Imaging RCTs and Implementation Science
- RCT Funding