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Class iii angina11/3/2022 ![]() ![]() The full document contains appendices that present definitions of angiographic coronary anatomy, special considerations, alternative imaging modalities, the Canadian Cardiovascular Society (CCS) classification of angina and the desired elements of a coronary angiographic report. This executive summary includes highlights of these discussions and a complete list of recommendations. The full document also discusses applications of coronary angiography in specific disease states and makes recommendations for its appropriate use in these conditions. This executive summary does not detail these general considerations, and the reader is referred to the full document for discussion of these important topics. The full report discusses some general considerations concerning the definition and purpose of coronary angiography, its accuracy and reproducibility, including a discussion of digital storage of coronary angiography, its limitations, risks and relative contraindications, the selection of a contrast agent for coronary angiography, pharmacological assessment for coronary spasm at the time of coronary angiography, and the use, cost, and cost-effectiveness of coronary angiography. Class iii angina trial#Level of Evidence B: The presence of a single randomized trial or nonrandomized studies. Level of Evidence A: The presence of multiple randomized clinical trials. The weight of evidence in support of the recommendation for each listed indication is presented as follows: These classes summarize the indications for coronary angiography as follows:Ĭlass I: Conditions for which there is evidence and/or general agreement that this procedure is useful and effective.Ĭlass II: Conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of performing the procedure.Ĭlass IIa: Weight of evidence/opinion is in favor of usefulness/ efficacy.Ĭlass IIb: Usefulness/efficacy is less well established by evidence/opinion.Ĭlass III: Conditions for which there is evidence and/or general agreement that the procedure is not useful/effective and in some cases may be harmful. This document uses the ACC/AHA classifications of class I, II, and III. Whereas randomized trials are often available for reference in the development of treatment guidelines, randomized trials regarding the use of diagnostic procedures such as coronary angiography are rarely available. Evidence was compiled and ranked by the committee. ![]() In addition to reviewing the original document, the committee conducted a search of the literature for the 10 years preceding development of these guidelines. Representatives from the family practice and internal medicine professions were also included on the committee. The committee appointed to develop this document included private practitioners and academicians who were selected to represent both experts in coronary angiography and senior clinician consultants. The frequent and still growing use of coronary angiography, its relatively high costs, its inherent risks, and the ongoing evolution of its indications provide the reasons for this revision. Reprints of both the full text and executive summary and recommendations are available from both organizations. The guidelines in their entirety, including the American College of Cardiology/American Heart Association (ACC/AHA) class I, II, and III recommendations, are published in the May 1999 issue of the Journal of the American College of Cardiology. ![]() This executive summary and recommendations appears in the May 4, 1999, issue of Circulation. This document revises and updates the original “Guidelines for Coronary Angiography,” published in 1987. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB). ![]()
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