Recommendations for Use of Radionuclide Testing for Risk Assessment/Prognosis in Patients With NSTEMI and UA

IndicationTestClassLevel of Evidence
1. Identification of inducible ischemia in the distribution of the “culprit lesion” or in remote areas in patients at intermediate or low risk for major adverse cardiac events.Stress MPI with ECG gating whenever possibleIB
2. Identification of the severity/extent of inducible ischemia in patients whose angina is satisfactorily stabilized with medical therapy or in whom diagnosis is uncertain.Stress MPI with ECG gating whenever possibleIA
3. Identification of hemodynamic significance of coronary stenosis after coronary arteriography.Stress MPIIB
4. Measurement of baseline LV function.RNA or gated SPECTIB
5. Identification of the severity/extent of disease in patients with ongoing suspected ischemia symptoms when ECG changes are not diagnostic.Rest MPIIIaB

ECG indicates electrocardiography; LV, left ventricular; MPI, myocardial perfusion imaging; RNA, radionuclide angiography; SPECT, single-photon emission computed tomography.