| Degree of maximal coronary stenosis | Interpretation | Management |
CAD-RADS 0 | 0% | ACS highly unlikely | - No further evaluation of ACS is required.
- Consider other etiologies.
|
CAD-RADS 1 | 1 to 24%* | ACS highly unlikely | - Consider evaluation of non-ACS etiology, if normal troponin and no ECG changes.
- Consider referral for outpatient follow-up for preventive therapy and risk factor modification.
|
CAD-RADS 2 | 25 to 49%¶ | ACS unlikely | - Consider evaluation of non-ACS etiology, if normal troponin and no ECG changes.
- Consider referral for outpatient follow-up for preventive therapy and risk factor modification.
- If clinical suspicion of ACS is high or if high-risk plaque features are noted, consider hospital admission with cardiology consultation.
|
CAD-RADS 3 | 50 to 69% | ACS possible | - Consider hospital admission with cardiology consultation, functional testing and/or ICA for evaluation and management.
- Recommendation for anti-ischemic and preventive management should be considered as well as risk factor modification. Other treatments should be considered if presence of hemodynamically significant lesion.
|
CAD-RADS 4 | A: 70 to 99% or B: >50% (left main) or ≥70% (3-vessel) obstructive disease | ACS likely | - Consider hospital admission with cardiology consultation. Further evaluation with ICA and revascularization as appropriate.
- Recommendation for anti-ischemic and preventive management should be considered as well as risk factor modification.
|
CAD-RADS 5 | 100% (total occlusion) | ACS very likely | - Consider expedited ICA on a timely basis and revascularization if appropriate if acute occlusion.Δ
- Recommendation for anti-ischemic and preventive management should be considered as well as risk factor modifications.
|
CAD-RADS N | Non-diagnostic study | ACS cannot be excluded | - Additional or alternative evaluation for ACS is needed.
|