Report from the EuroEcho and Imaging Conference- Leipzig, Germany

Guest blog author: Dr. Wael Jaber - Chair, ASNC - EACVI Session 
Multimodality cardiac imaging trials in coronary artery disease: viewpoints “across the Ocean” was the first joint ASNC/EACVI session to be held at EuroEcho and Imaging Conference, co-sponsored by the American Society of Nuclear Cardiology (ASNC). The four speakers addressed all recent cardiac imaging related trials with focus on clinical implications in daily practice. The session took a tour de force by Dr. Danilo Neglia from an Italian lead European trial (E-VINCI), to a review of COURAGE and PROMISE  and a new risk score by Dr. Cremer that can outperform the Forester-Diamond score. In return, we learned about the value and downstream course of testing from a presentation from the UK-MARC 1 and 2 studies. The two studies used SPECT, and Perfusion MRI or later a NICE guided management to patients presenting with possible coronary disease. Finally, we had a review by Dr. Thomas of STICH and PARR-2 studies and their role in guiding viability testing. We learned the major shortcomings of STICH as an observational non-randomized “viability” trial utilizing outdated and inconsistent testing modality in an open label fashion and in some but not all patients in the overall study. The chairs and the speakers all agreed that optimal medical therapy should be the initial management of patients with suspected or confirmed coronary artery disease. Any future trial should include an optimal medical therapy arm in addition to the imaging arm/s.