Evidence-based recommendation for surveillance of asymptomatic coronary artery disease (IGHG a)

This page is part of the PanCare follow-up recommendations for surveillance of late effects. Click here, for more information on these recommendations.

Who is at risk for asymptomatic coronary artery disease?

CAYA cancer survivors treated with

  • radiotherapy to a volume exposing the heart

What surveillance modality should be used and at what frequency should it be performed?

  • No recommendation can be formulated for routine surveillance of asymptomatic abnormalities of the coronary arteries b
  • Surveillance for modifiable cardiovascular disease risk factors (hypertension, dyslipidaemia, diabetes, overweight or obesity, smoking and physical activity) according to national or local guidelines, which may involve referral to a cardiovascular specialist starting no later than at the age of 40 years, and at least every 5 years subsequently c

What should be done if abnormalities are identified?

  • Timely management of all modifiable cardiovascular disease risk factors


While PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication, we acknowledge that the sequence of referral and diagnostic tests might vary according to the local and national healthcare system logistics.

It is recognised that survivors and their healthcare professionals have the final responsibility for making decisions concerning their long-term follow-up care. As such, they may choose to either adopt these recommendations or not to do so after individual informed discussion. It is good practice to document this decision.

In addition to regular surveillance, real-time awareness and prompt reporting of new symptoms and signs is essential to the early detection and timely treatment of late effects.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

a This recommendation reflects the recommendations of the preliminary evidence-based IGHG Coronary artery disease guideline. The guideline will be published in a peer-reviewed journal soon.

b There is currently insufficient evidence to determine the diagnostic value of surveillance options for asymptomatic abnormalities of the coronary arteries and whether early detection of abnormalities of the coronary arteries reduces morbidity and mortality.

c Timing of initiation and frequency should be based on the intensity of cardiotoxic treatment exposure(s), family history and presence of co-morbid conditions associated with cardiovascular disease risk