ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate Use Criteria for Coronary Revascularization Focused Update

A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography

• One- or 2-vessel CAD without involvement of proximal LAD

• Low-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• One- or 2-vessel CAD without involvement of proximal LAD

• Low-risk findings on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• One- or 2-vessel CAD without involvement of proximal LAD

• Intermediate-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• One- or 2-vessel CAD without involvement of proximal LAD

• Intermediate-risk findings on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• One- or 2-vessel CAD without involvement of proximal LAD

• High-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• One- or 2-vessel CAD without involvement of proximal LAD

• High-risk findings on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• One- or 2-vessel CAD without involvement of proximal LAD

• No noninvasive testing performed

• One- or 2-vessel CAD with borderline stenosis “50% to 60%”

• No noninvasive testing performed

• No further invasive evaluation performed (i.e., FFR, IVUS)

• One- or 2-vessel CAD with borderline stenosis “50% to 60%”

• No noninvasive testing performed or equivocal test results present

• FFR less than or equal to 0.80^⁎ and/or IVUS with significant reduction in cross-sectional area

• One- or 2-vessel CAD with borderline stenosis “50% to 60%”

• No noninvasive testing performed or equivocal test results present

• FFR or IVUS findings do not meet criteria for significant stenosis

• Chronic total occlusion of 1 major epicardial coronary artery, without other coronary stenoses

• Low-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• Chronic total occlusion of 1 major epicardial coronary artery, without other coronary stenoses

• Low-risk findings on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• Chronic total occlusion of 1 major epicardial coronary artery, without other coronary stenoses

• Intermediate-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• Chronic total occlusion of 1 major epicardial coronary artery, without other coronary stenoses

• Intermediate-risk criteria on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• Chronic total occlusion of 1 major epicardial coronary artery, without other coronary stenoses

• High-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• Chronic total occlusion of 1 major epicardial coronary artery, without other coronary stenoses

• High-risk criteria on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• One-vessel CAD involving the proximal LAD

• Low-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• One-vessel CAD involving the proximal LAD

• Low-risk findings on noninvasive testing

• Receiving maximal anti-ischemic medical therapy

• One-vessel CAD involving the proximal LAD

• Intermediate-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• One-vessel CAD involving the proximal LAD

• Intermediate-risk findings on noninvasive testing

• Receiving maximal anti-ischemic medical therapy

• One-vessel CAD involving the proximal LAD

• High-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• One-vessel CAD involving the proximal LAD

• High-risk findings on noninvasive testing

• Receiving maximal anti-ischemic medical therapy

• Two-vessel CAD involving the proximal LAD

• Low-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• Two-vessel CAD involving the proximal LAD

• Low-risk findings on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• Two-vessel CAD involving the proximal LAD

• Intermediate-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• Two-vessel CAD involving the proximal LAD

• Intermediate-risk findings on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• Two-vessel CAD involving the proximal LAD

• High-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• Two-vessel CAD involving the proximal LAD

• High-risk findings on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• Three-vessel CAD (no left main)

• Low-risk findings on noninvasive testing including normalLV systolic function

• Receiving no or minimal anti-ischemic medical therapy

• Three-vessel CAD (no left main)

• Low-risk findings on noninvasive testing including normalLV systolic function

• Receiving a course of maximal anti-ischemic medical therapy

• Three-vessel CAD (no left main)

• Intermediate-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• Three-vessel CAD (no left main)

• Intermediate-risk findings on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• Three-vessel CAD (no left main)

• High-risk findings on noninvasive testing

• Receiving no or minimal anti-ischemic medical therapy

• Three-vessel CAD (no left main)

• High-risk findings on noninvasive testing

• Receiving a course of maximal anti-ischemic medical therapy

• Three-vessel CAD (no left main)

• Abnormal LV systolic function