Cardiac CT vs. Stress Testing in Patients with Suspected Coronary Artery Disease: Review and Expert Recommendations

Abstract

Diagnosis and management of coronary artery disease represent a major challenge to our health care systems affecting millions of patients each year. Until recently, the diagnosis of coronary artery disease could be conclusively determined only by invasive coronary angiography. To avoid risks from cardiac catheterization, many healthcare systems relied on stress testing as gatekeeper for coronary angiography. Advancements in cardiac computed tomography angiography technology now allows to noninvasively visualize coronary artery disease, challenging the role of stress testing as the default noninvasive imaging tool for evaluating patients with chest pain. In this review, we summarize current data on the clinical utility of cardiac computed tomography and stress testing in stable patients with suspected coronary artery disease.

Total coronary atherosclerotic plaque burden assessment by CT angiography for detecting obstructive coronary artery disease associated with myocardial perfusion abnormalities

“…20 Future investigations will define the role of coronary atheroma quantification for clinical management, particularly, in comparison to the many emerging tools available with cardiac CT, e.g, myocardial perfusion imaging, CT-FFR, or transluminal attenuation gradient assessment. 21 …”

Application of double low dose combined low flow injection in coronary dual‐source coronary computed tomography angiography

“…1,2 Accumulating evidences have demonstrated that noninvasive CCTA was the preferred examination method of coronary artery disease (CAD). 1,2 Accumulating evidences have demonstrated that noninvasive CCTA was the preferred examination method of coronary artery disease (CAD).…”

“…Coronary computed tomography angiography (CCTA) has been wellknown as a noninvasive, strong security, and convenient technique providing visualized and reliable pathological results for clinical diagnosis. 1,2 Accumulating evidences have demonstrated that noninvasive CCTA was the preferred examination method of coronary artery disease (CAD). It had the advantage of high sensitivity and specificity as well as negative predictive value in comparison with invasive CCTA which was served as the standard of reference for the detection of CAD due to its high temporal resolution and spatial resolution.…”

Difficulties of Diagnostics of Obstructive Coronary Artery Lesions in Patients with Stable Ischemic Heart Disease and Possibilities of Single-Photon Emission Computed Tomography

“…Эти данные вполне согласуются с результатами многоцентровых исследований [20,21], в которых отмечена лишь умеренная точность ОФЭКТ в выявлении ИБС -значения ROC-кривой были в пределах 0,67-0,69. У целого ряда исследователей [13,22] складывается впечатление, что это является общей проблемой для неинвазивных тестов по выявлению ишемии миокарда, которые уступают в диагностических возможностях МСКТ-ангиографии КА.…”