Clinical Trials for the Diagnosis and Management of Stable Ischaemic Heart Disease: Context, Status, and Future Implications

*David Corcoran,1,2 Kenneth Mangion,1,2 †Colin Berry1,2

1. West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK
2. British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and
Medical Sciences, University of Glasgow, Glasgow, UK
*Correspondence to dcorcoran@nhs.net
†All authors contributed equally

Disclosure: Prof Berry was a co-applicant on the British Heart Foundation Special Project Grant
(SP/12/1/29062) that supports the CEMARC 2 clinical trial. He is a Steering Committee Member of
MR-INFORM and SCOT-HEART. Prof Berry is named on institutional research and consultancy agreements between the University of Glasgow and St. Jude Medical and similarly a research agreement with Siemens Healthcare. The other authors have declared no conflicts of interest.
Received: 22.02.16 Accepted: 09.09.16
Citation: EMJ Cardiol. 2016;4[1]:112-121.

Abstract

Chest pain and coronary artery disease (CAD) impose a substantial burden on public health and society. Diagnostic imaging tests are used by clinicians to identify the presence and extent of epicardial coronary disease and/or its consequences, including ischaemia, infarction, and left ventricular dysfunction.

In this article, we discuss current practice guideline recommendations for the diagnosis and management of patients with suspected or known CAD, and the need for more evidence from clinical trials. We then focus on the recently published and ongoing multicentre clinical trials of imaging-based strategies for the diagnosis and management of ischaemic heart disease, and the potential future impact of these trials on clinical practice. The results of these trials have the potential to bring radical changes to the practice of cardiology in the future.

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