What are the ACP guidelines on acute coronary syndrome (ACS) screening?

Updated: Sep 30, 2020
  • Author: David L Coven, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

In 2015, the American College of Physicians (ACP) released guidelines on screening for coronary heart disease (CHD), including the following [15] :

  • There is no evidence that cardiac screening improves patient outcomes in asymptomatic, low-risk adults.

  • Potential harms of cardiac screening include false-positive results causing patients to undergo potentially unnecessary tests and procedures.

  • Among adults at low risk, prevalence of coronary heart disease is low, and cardiac screening is of low predictive value. Therefore, cardiac screening is of low yield, and the probability that positive findings will influence therapeutic decision making is low.

  • Clinicians should therefore emphasize strategies to reduce cardiovascular risk even further among low-risk adults by treating modifiable risk factors (smoking, diabetes, blood pressure, hyperlipidemia, overweight, and exercise).

  • Clinicians should not screen asymptomatic, low-risk adults for cardiac disease using resting or stress electrocardiography, stress echocardiography, or stress myocardial perfusion imaging.

  • Clinicians should conduct cardiovascular risk assessment with a global risk score combining individual risk factor measurements into a single quantitative estimate of risk.

  • The ACP recommendations do not apply to symptomatic patients or to screening athletes before participation in various events.


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