{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:05:37Z","timestamp":1792789537406,"version":"4.5.0"},"reference-count":203,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:00:00Z","timestamp":1682380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Philips (The Netherlands)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Clinical and economic burdens exist within the coronary artery disease (CAD) care pathway despite advances in diagnosis and treatment and the increasing utilization of percutaneous coronary intervention (PCI). However, research presenting a comprehensive assessment of the challenges across this pathway is scarce. This contemporary review identifies relevant studies related to inefficiencies in the diagnosis, treatment, and management of CAD, including clinician, patient, and economic burdens. Studies demonstrating the benefits of integration and automation within the catheterization laboratory and across the CAD care pathway were also included. Most studies were published in the last 5\u201310 years and focused on North America and Europe. The review demonstrated multiple potentially avoidable inefficiencies, with a focus on access, appropriate use, conduct, and follow-up related to PCI. Inefficiencies included misdiagnosis, delays in emergency care, suboptimal testing, longer procedure times, risk of recurrent cardiac events, incomplete treatment, and challenges accessing and adhering to post-acute care. Across the CAD pathway, this review revealed that high clinician burnout, complex technologies, radiation, and contrast media exposure, amongst others, negatively impact workflow and patient care. Potential solutions include greater integration and interoperability between technologies and systems, improved standardization, and increased automation to reduce burdens in CAD and improve patient outcomes.<\/jats:p>","DOI":"10.3390\/ijerph20095633","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T04:27:02Z","timestamp":1682396822000},"page":"5633","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Challenges and Burdens in the Coronary Artery Disease Care Pathway for Patients Undergoing Percutaneous Coronary Intervention: A Contemporary Narrative Review"],"prefix":"10.3390","volume":"20","author":[{"given":"Monika","family":"Kodeboina","sequence":"first","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"},{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy"},{"name":"Clinic for Internal Medicine and Cardiology, Marien Hospital, 52066 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9746-7592","authenticated-orcid":false,"given":"Kerstin","family":"Piayda","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Frankfurt, 60389 Frankfurt, Germany"},{"name":"Department of Cardiology and Vascular Medicine, Medical Faculty, Justus-Liebig-University Giessen, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Jenniskens","sequence":"additional","affiliation":[{"name":"Philips, 5684 PC Best, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pearl","family":"Vyas","sequence":"additional","affiliation":[{"name":"Philips, 5684 PC Best, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Chen","sequence":"additional","affiliation":[{"name":"Philips, San Diego, CA 92130, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon Julian","family":"Pesigan","sequence":"additional","affiliation":[{"name":"Philips, 5684 PC Best, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Ferko","sequence":"additional","affiliation":[{"name":"EVERSANA, Burlington, ON L7N 3H8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3966-3226","authenticated-orcid":false,"given":"Barkha P.","family":"Patel","sequence":"additional","affiliation":[{"name":"EVERSANA, Burlington, ON L7N 3H8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Dobrin","sequence":"additional","affiliation":[{"name":"EVERSANA, Burlington, ON L7N 3H8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1534-9231","authenticated-orcid":false,"given":"Jayson","family":"Habib","sequence":"additional","affiliation":[{"name":"EVERSANA, Burlington, ON L7N 3H8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Franke","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Frankfurt, 60389 Frankfurt, Germany"},{"name":"Philips Chief Medical Office, 22335 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"key":"ref_1","first-page":"e9349","article-title":"Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study","volume":"12","author":"Khan","year":"2020","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2017.04.052","article-title":"Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015","volume":"70","author":"Roth","year":"2017","journal-title":"J. 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