J Transcat Intervent.2020;28:eA202006.
Optimizing coronary angiography in Brazil: a legacy from the COVID-19 era
DOI: 10.31160/JOTCI202028A202006
At the time this editorial is written, a new reality is under construction in medicine all over the world. The pandemic associated with the severe acute respiratory syndrome (SARS-CoV-2) coronavirus 2 continues to advance, imposing an unprecedented burden on several health systems around the world. In Brazil, the scarcity of resources and the risk of contamination are daily concerns for health managers and professionals, placing the rational use of diagnostic tests and therapeutic interventions as priority measures in all medical specialties in the public and private sectors. In this context, it is essential that the indications for invasive procedures, which could expose both the professional and the patient to the risk of contamination by SARS-CoV-2, are accurate. Containing the pandemic and preventing the collapse of the Unified Health System (SUS) are paramount.
Although coronary angiography is an exam with known and potentially severe complications, the current scenario requires an even more rigorous selection of patients., World-renowned cardiology societies have developed guidelines aimed to reduce the potential risk of transmission during the procedure, but undoubtedly prevention already begins in its indication. Knowing the predictors of absence of obstructive coronary artery disease (CAD) on the exam is essential for the implementation of this strategy, and may also leave a valuable legacy for the post-pandemic era. Currently, the American College of Cardiology (ACC) recognizes the prevalence of normal exams found in the literature to be large, because it depends on a series of clinical variables. Nevertheless, the best results remain in the 20% range – a figure far from ideal in the context of the current pandemic.
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