From the Guidelines
SCAI stands for the Society for Cardiovascular Angiography and Interventions, which is the primary professional organization for invasive and interventional cardiologists, focusing on advancing care for patients with cardiovascular disease through education, advocacy, research, and quality improvement initiatives. This society provides guidelines for best practices in cardiac catheterization, percutaneous coronary interventions (PCI), structural heart procedures, and peripheral vascular interventions, as outlined in the 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes 1. The organization offers certification programs, hosts annual scientific sessions, and publishes the Catheterization and Cardiovascular Interventions journal. For cardiovascular professionals, membership in SCAI provides access to clinical resources, training opportunities, and networking with colleagues specializing in interventional cardiology.
Some key aspects of SCAI's guidelines and recommendations include:
- The importance of careful evaluation of patient history, including the characterization of anginal symptoms, and evaluation of risk factors and manifestations of CVD, as well as proper physical examination and basic testing, for the diagnosis and management of CCS 1
- The use of non-invasive functional imaging or anatomical imaging using coronary CTA as the initial test to rule-out or establish the diagnosis of CCS, unless obstructive CAD can be excluded based on clinical evaluation alone 1
- The consideration of both anatomy and functional evaluation for revascularization decisions, with either non-invasive or invasive functional evaluation required for the assessment of myocardial ischaemia associated with angiographic stenosis, unless very high grade (>90% diameter stenosis) 1
- The assessment of risk to identify CCS patients at high event risk who are projected to derive prognostic benefit from revascularization, including the assessment of LV function 1
Overall, SCAI plays a crucial role in shaping standards of care and advancing technologies in the field of interventional cardiology, with a focus on improving patient outcomes and reducing morbidity and mortality. The most recent and highest quality study, the 2019 ESC guidelines, provides the foundation for SCAI's recommendations and guidelines 1.
From the Research
SCAI Guidelines and Recommendations
- The 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes incorporates new evidence and updates previous guidelines 2
- The guideline includes recommendations for the management of patients with acute coronary syndromes, including those with coronary artery disease (CAD)
Management of Coronary Artery Disease
- Beta-blockers remain one of the cornerstones in the management of coronary artery disease, both in chronic stable angina and myocardial infarction 3
- Recent studies have questioned the beneficial effect of beta-blockers in the management of patients with stable ischemic heart disease and myocardial infarction 3
- Angiotensin-converting enzyme (ACE) inhibitors and beta-blockers have been shown to be effective in reducing mortality in patients with CAD, particularly in those with obstructive CAD 4
Use of Medications in CAD Management
- The use of antiplatelet drugs, beta-blockers, statins, and ACE inhibitors or angiotensin receptor blockers is prevalent in older patients with CAD, with reported usage rates of 98%, 96%, 87%, and 85%, respectively 5
- Therapy with statins, beta-blockers, and ACE inhibitors has been shown to reduce plasma myeloperoxidase levels in patients with CAD, particularly in those with acute coronary syndromes 6