324 - CHEST PAIN, CAD, AND PCI CONTROVERSIES

49 yr. female with chest pain-Evolving approach to undifferentiated chest pain -“Raising the evidence bar”
I. Stress testing and imaging
II. Emerging importance of CT angiography and decline of the “cardiac cath as the gold standard”

Time to change practice with PCI”- early adoption of antiplatelet “de-escalation” strategies
I. 80 yr. frail female with CKD=” High bleed risk”
a) ACS: Inferior STEMI-PCI of RCA with MVCAD
b) SIHD: PCI RCA with MVCAD for stable angina
c) ACS & SIHD with PCI & atrial fibrillation

II. 40 yr female with PCI for single vessel disease/normal EF
a) ACS and SIHD
i. Role of SAPT with DAPT for 1 month post PCI
ii. SAPT should be P2Y12 receptor inhibitor and “ditch ASA”