| Degree of maximal coronary stenosis | Interpretation | Further cardiac investigation | Management |
CAD-RADS 0 | 0% (no plaque or stenosis) | Documented absence of CAD | None | - Reassurance. Consider non-atherosclerotic causes of chest pain.
|
CAD-RADS 1 | 1 to 24% (minimal stenosis or plaque with no stenosis*) | Minimal non-obstructive CAD | None | - Consider non-atherosclerotic causes of chest pain.
- Consider preventive therapy and risk factor modification.
|
CAD-RADS 2 | 25 to 49% (mild stenosis) | Mild non-obstructive CAD | None | - Consider non-atherosclerotic causes of chest pain.
- Consider preventive therapy and risk factor modification, particularly for patients with non-obstructive plaque in multiple segments.
|
CAD-RADS 3 | 50 to 69% (moderate stenosis) | Moderate stenosis | Consider functional assessment | - Consider symptom-guided anti-ischemic and preventive pharmacotherapy as well as risk factor modification per guideline-directed care.¶
- Other treatments should be considered per guideline-directed care.¶
|
CAD-RADS 4 | A: 70 to 99% (severe stenosis) or B: >50% (left main) or ≥70% (3-vessel) obstructive disease | Severe stenosis | A: Consider ICA or functional assessment B: ICA is recommended | - Consider symptom-guided anti-ischemic and preventive pharmacotherapy as well as risk factor modification per guideline-directed care.¶
- Other treatments (including options of revascularization) should be considered per guideline-directed care.¶
|
CAD-RADS 5 | 100% (total occlusion) | Total coronary occlusion | Consider ICA and/or viability assessment | - Consider symptom-guided anti-ischemic and preventive pharmacotherapy as well as risk factors modification per guideline-directed care.¶
- Other treatments (including options of revascularization) should be considered per guideline-directed care.¶
|
CAD-RADS N | Non-diagnostic study | Obstructive CAD cannot be excluded | Additional or alternative evaluation may be needed | |