Normal stress or no change of limited resting wall motion abnormalities during stress 4. CAC score 100 Agatston units 5. No coronary stenosis 50% on CCTA *Although the published data are limited; patients with these findings will probably not be at low risk in the presence of either a high-risk treadmill score or severe resting LV dysfunction (LVEF 35%). CAC indicates coronary artery calcium; CAD, coronary artery disease; CCTA, coronary computed tomography angiography; LV, left ventricular; LVEF, left ventricular ejection fraction; and MI, myocardial infarction. Adapted from Gibbons et al.7 Fihn et al Stable Ischemic Heart Disease: Full Text e389 Adapted from Snow et al.377a Reduce premature cardiovascular death; Prevent complications of SIHD that directly or indirectly impair patients functional well-being, including nonfatal AMI and heart failure; Maintain or restore a level of activity, functional capacity, and quality of life that is satisfactory to the patient; Completely, or nearly completely, eliminate ischemic symptoms; and Minimize costs of health care, in particular by eliminating avoidable adverse effects of tests and treatments, by pre- venting hospital admissions, and by eliminating unneces- sary tests and treatments. These goals are pursued with 5 fundamental, complemen- tary, and overlapping strategies: 1. Educate patients about the etiology, clinical manifesta- tions, treatment options, and prognosis of IHD, to support active participation of patients in their treatment decisions. 2. Identify and treat conditions that contribute to, worsen, or complicate IHD. 3. Effectively modify risk factors for IHD by both phar- macological and nonpharmacological methods. 4. Use evidence-based pharmacological treatments to im- prove patients health status and survival, with attention to avoiding drug interactions and side effects. 5. Use revascularization by percutaneous catheter-based techniques or CABG when there is clear evidence of the potential to improve patients health status and survival. 4.2. 