Table 2

Patients Without Prior Bypass Surgery

IndicationAppropriate Use Score (1–9)
CCS Angina ClassAsymptomaticI or IIIII or IV
14.
  • One- or 2-vessel CAD without involvement of proximal LAD

  • Low-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

I (1)I (2)U (5)
15.
  • 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

I (2)U (5)A (7)
16.
  • One- or 2-vessel CAD without involvement of proximal LAD

  • Intermediate-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

I (3)U (5)U (6)
17.
  • 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

U (4)A (7)A (8)
18.
  • One- or 2-vessel CAD without involvement of proximal LAD

  • High-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

U (6)A (7)A (8)
19.
  • 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

A (7)A (8)A (9)
20.
  • One- or 2-vessel CAD without involvement of proximal LAD

  • No noninvasive testing performed

I (3)U (5)A (7)
21.
  • One- or 2-vessel CAD with borderline stenosis “50% to 60%”

  • No noninvasive testing performed

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

Not ratedI (2)I (3)
22.
  • 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

I (3)U (6)A (7)
23.
  • 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

I (1)I (2)I (2)
24.
  • 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

I (1)I (2)I (3)
25.
  • 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

I (1)U (4)U (6)
26.
  • 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

I (3)U (4)U (6)
27.
  • 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

U (4)U (5)A (7)
28.
  • 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

U (4)U (5)A (7)
29.
  • 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

U (5)A (7)A (8)
30.
  • One-vessel CAD involving the proximal LAD

  • Low-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

U (4)U (5)A (7)
31.
  • One-vessel CAD involving the proximal LAD

  • Low-risk findings on noninvasive testing

  • Receiving maximal anti-ischemic medical therapy

U (4)A (7)A (8)
32.
  • One-vessel CAD involving the proximal LAD

  • Intermediate-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

U (4)U (6)A (7)
33.
  • One-vessel CAD involving the proximal LAD

  • Intermediate-risk findings on noninvasive testing

  • Receiving maximal anti-ischemic medical therapy

U (5)A (8)A (9)
34.
  • One-vessel CAD involving the proximal LAD

  • High-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

A (7)A (8)A (9)
35.
  • One-vessel CAD involving the proximal LAD

  • High-risk findings on noninvasive testing

  • Receiving maximal anti-ischemic medical therapy

A (7)A (9)A (9)
36.
  • Two-vessel CAD involving the proximal LAD

  • Low-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

U (4)U (6)A (7)
37.
  • Two-vessel CAD involving the proximal LAD

  • Low-risk findings on noninvasive testing

  • Receiving a course of maximal anti-ischemic medical therapy

U (5)A (7)A (8)
38.
  • Two-vessel CAD involving the proximal LAD

  • Intermediate-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

U (5)A (7)A (8)
39.
  • Two-vessel CAD involving the proximal LAD

  • Intermediate-risk findings on noninvasive testing

  • Receiving a course of maximal anti-ischemic medical therapy

U (6)A (7)A (9)
40.
  • Two-vessel CAD involving the proximal LAD

  • High-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

A (7)A (8)A (9)
41.
  • Two-vessel CAD involving the proximal LAD

  • High-risk findings on noninvasive testing

  • Receiving a course of maximal anti-ischemic medical therapy

A (8)A (9)A (9)
42.
  • Three-vessel CAD (no left main)

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

  • Receiving no or minimal anti-ischemic medical therapy

U (5)U (6)A (7)
43.
  • 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

U (5)A (7)A (8)
44.
  • Three-vessel CAD (no left main)

  • Intermediate-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

A (7)A (7)A (8)
45.
  • Three-vessel CAD (no left main)

  • Intermediate-risk findings on noninvasive testing

  • Receiving a course of maximal anti-ischemic medical therapy

A (7)A (8)A (9)
46.
  • Three-vessel CAD (no left main)

  • High-risk findings on noninvasive testing

  • Receiving no or minimal anti-ischemic medical therapy

A (7)A (8)A (9)
47.
  • Three-vessel CAD (no left main)

  • High-risk findings on noninvasive testing

  • Receiving a course of maximal anti-ischemic medical therapy

A (8)A (9)A (9)
48.
  • Three-vessel CAD (no left main)

  • Abnormal LV systolic function

A (8)A (9)A (9)
49.
  • Left main stenosis

A (9)A (9)A (9)

New and updated indications are shaded blue.

A = appropriate; CAD = coronary artery disease; CCS = Canadian Cardiovascular Society; I = inappropriate; LAD = left anterior descending coronary artery; LV = left ventricular; LVEF = left ventricular ejection fraction; U = uncertain.

  • FFR cut point updated from 0.75 to 0.80 to reflect new literature since publication of the original document and to maintain consistency with guidelines (18).