Evidence map›Paper›PMID 27717538›Full record

ReviewTrends in cardiovascular medicine2017

Non-invasive assessment of low- and intermediate-risk patients with chest pain.

Pelbreton C Balfour, Jorge A Gonzalez, Christopher M Kramer

Open access · greenAbstract readReview
In one paragraph

Review in Trends in cardiovascular medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Ischemia during exercise stress testing, an indication of coronary vasomotor dysfunction?International journal of cardiology. Heart & vasculature · 2025
    Article
  4. Examining the Effects of Different Exertion Levels and Reference Standards on the Diagnostic Accuracy of Exercise ECG for Detecting Coronary Artery Disease - A Pilot Study.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2025
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Myocardial strain analysis as a non-invasive screening test in the diagnosis of stable coronary artery disease.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2021
    Article
  14. Review
  15. Article
  16. Prognostic accuracy of myocardial perfusion imaging in octogenarians.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018
    Article
  17. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Pelbreton C BalfourDepartment of Medicine (Cardiology), Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA.
Jorge A GonzalezDepartment of Medicine (Cardiology), Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA.
Christopher M KramerDepartment of Medicine (Cardiology), Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, VA; Department of Radiology, University of Virginia Health System, Charlottesville, VA. Electronic address: ckramer@virginia.edu.
Imaging Center · USUniversity of Virginia Health System · US

Funding

HCMR Novel Markers of Prognosis in Hypertrophic CardiomyopathyU01HL117006 · NHLBI · UNIVERSITY OF VIRGINIA · PI KRAMER, CHRISTOPHER M., NEUBAUER, STEFAN · 2013 to 2017
$14.5M
Comprehensive Magnetic Resonance in PADR01HL075792 · NHLBI · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI KRAMER, CHRISTOPHER M. · 2003 to 2021
$10.5M
Training in Cardiovascular Imaging ResearchT32EB003841 · NIBIB · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI Jonathan R Lindner · 2004 to 2026
$4.4M
NHLBI NIH HHS R01 HL075792NHLBI NIH HHS U01 HL117006NIBIB NIH HHS T32 EB003841
6 · The paper itself

Abstract

Coronary artery disease (CAD) remains a significant global public health burden despite advancements in prevention and therapeutic strategies. Common non-invasive imaging modalities, anatomic and functional, are available for the assessment of patients with stable chest pain. Exercise electrocardiography is a long-standing method for evaluation for CAD and remains the initial test for the majority of patients who can exercise adequately with a baseline interpretable electrocardiogram. The addition of cardiac imaging to exercise testing provides incremental benefit for accurate diagnosis for CAD and is particularly useful in patients who are unable to exercise adequately and/or have uninterpretable electrocardiograms. Radionuclide myocardial perfusion imaging and echocardiography with exercise or pharmacological stress provide high sensitivity and specificity in the detection and further risk stratification of patients with CAD. Recently, coronary computed tomography angiography has demonstrated its growing role to rule out significant CAD given its high negative predictive value. Although less available, stress cardiac magnetic resonance provides a comprehensive assessment of cardiac structure and function and provides a high diagnostic accuracy in the detection of CAD. The utilization of non-invasive testing is complex due to various advantages and limitations, particularly in the assessment of low- and intermediate-risk patients with chest pain, where no single study is suitable for all patients. This review will describe currently available non-invasive modalities, along with current evidence-based guidelines and appropriate use criteria in the assessment of low- and intermediate-risk patients with suspected, stable CAD.

Indexed as

Diagnostic ImagingElectrocardiographyAngina PectorisComputed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseEchocardiographyHumansMagnetic Resonance ImagingMyocardial Perfusion ImagingPredictive Value of TestsPrognosisRisk AssessmentRisk FactorsCardiac magnetic resonance imagingCoronary artery diseaseCoronary computed tomography angiographyExercise electrocardiographyNon-invasive imagingRadionuclide myocardial perfusion imagingRisk stratificationStress echocardiography

Identifiers

PMID27717538
PMCPMC5346457
OpenAlexW2519213815

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.