Impact of risk stratification on cardiovascular outcomes in patients with stable chest pain

Abstract

Chest pain is a common presenting complaint among patients visiting primary care1 and is a frequent reason for referral to the outpatient cardiology clinic. The European Society of Cardiology (ESC) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines advocate estimating pre-test probability (PTP) of obstructive coronary artery disease (CAD) in the evaluation of stable chest pain in order to guide the need for and type of downstream investigations.2,3 The PTP of obstructive CAD depends on the clinical characteristics of the patient and disease prevalence. Since the introduction of the Diamond-Forrester model in 1979,4 contemporary risk scores, such as the CAD consortium score5 (CCS) and the ESC 2019 PTP risk score,2 have been developed.