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Risk stratification for coronary artery disease in multi-ethnic populations: Are there broader considerations for cost efficiency?
Coronary artery disease (CAD) screening and diagnosis are core cardiac specialty services. From symptoms, autopsy correlations supported reductions in coronary blood flow and dynamic epicardial and microcirculatory coronaries artery disease as etiologies. While angina remains a clinical diagnosis, m...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354077/ https://www.ncbi.nlm.nih.gov/pubmed/30705870 http://dx.doi.org/10.5662/wjm.v9.i1.1 |
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author | Iyngkaran, Pupalan Chan, William Liew, Danny Zamani, Jalal Horowitz, John D Jelinek, Michael Hare, David L Shaw, James A |
author_facet | Iyngkaran, Pupalan Chan, William Liew, Danny Zamani, Jalal Horowitz, John D Jelinek, Michael Hare, David L Shaw, James A |
author_sort | Iyngkaran, Pupalan |
collection | PubMed |
description | Coronary artery disease (CAD) screening and diagnosis are core cardiac specialty services. From symptoms, autopsy correlations supported reductions in coronary blood flow and dynamic epicardial and microcirculatory coronaries artery disease as etiologies. While angina remains a clinical diagnosis, most cases require correlation with a diagnostic modality. At the onset of the evidence building process much research, now factored into guidelines were conducted among population and demographics that were homogenous and often prior to newer technologies being available. Today we see a more diverse multi-ethnic population whose characteristics and risks may not consistently match the populations from which guideline evidence is derived. While it would seem very unlikely that for the majority, scientific arguments against guidelines would differ, however from a translational perspective, there will be populations who differ and importantly there are cost-efficacy questions, e.g., the most suitable first-line tests or what parameters equate to an adequate test. This article reviews non-invasive diagnosis of CAD within the context of multi-ethnic patient populations. |
format | Online Article Text |
id | pubmed-6354077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-63540772019-01-31 Risk stratification for coronary artery disease in multi-ethnic populations: Are there broader considerations for cost efficiency? Iyngkaran, Pupalan Chan, William Liew, Danny Zamani, Jalal Horowitz, John D Jelinek, Michael Hare, David L Shaw, James A World J Methodol Review Coronary artery disease (CAD) screening and diagnosis are core cardiac specialty services. From symptoms, autopsy correlations supported reductions in coronary blood flow and dynamic epicardial and microcirculatory coronaries artery disease as etiologies. While angina remains a clinical diagnosis, most cases require correlation with a diagnostic modality. At the onset of the evidence building process much research, now factored into guidelines were conducted among population and demographics that were homogenous and often prior to newer technologies being available. Today we see a more diverse multi-ethnic population whose characteristics and risks may not consistently match the populations from which guideline evidence is derived. While it would seem very unlikely that for the majority, scientific arguments against guidelines would differ, however from a translational perspective, there will be populations who differ and importantly there are cost-efficacy questions, e.g., the most suitable first-line tests or what parameters equate to an adequate test. This article reviews non-invasive diagnosis of CAD within the context of multi-ethnic patient populations. Baishideng Publishing Group Inc 2019-01-18 /pmc/articles/PMC6354077/ /pubmed/30705870 http://dx.doi.org/10.5662/wjm.v9.i1.1 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Review Iyngkaran, Pupalan Chan, William Liew, Danny Zamani, Jalal Horowitz, John D Jelinek, Michael Hare, David L Shaw, James A Risk stratification for coronary artery disease in multi-ethnic populations: Are there broader considerations for cost efficiency? |
title | Risk stratification for coronary artery disease in multi-ethnic populations: Are there broader considerations for cost efficiency? |
title_full | Risk stratification for coronary artery disease in multi-ethnic populations: Are there broader considerations for cost efficiency? |
title_fullStr | Risk stratification for coronary artery disease in multi-ethnic populations: Are there broader considerations for cost efficiency? |
title_full_unstemmed | Risk stratification for coronary artery disease in multi-ethnic populations: Are there broader considerations for cost efficiency? |
title_short | Risk stratification for coronary artery disease in multi-ethnic populations: Are there broader considerations for cost efficiency? |
title_sort | risk stratification for coronary artery disease in multi-ethnic populations: are there broader considerations for cost efficiency? |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354077/ https://www.ncbi.nlm.nih.gov/pubmed/30705870 http://dx.doi.org/10.5662/wjm.v9.i1.1 |
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