Current Evidence in Cardiothoracic Imaging: Growing Evidence for Coronary Computed Tomography Angiography as a First-line Test in Stable Chest Pain

Journal of Thoracic Imaging
Christopher D MaroulesSuhny Abbara

Abstract

Coronary computed tomography angiography (CCTA) is a validated technique for the evaluation of patients with suspected coronary artery disease, showing high accuracy compared with invasive coronary angiography and high negative predictive value. CCTA is also well positioned as a first-line test for the evaluation of stable chest pain. This purpose of this review is to examine the evidence behind CCTA in the setting of stable chest pain, with attention to 5 key strengths of a CCTA-based approach: (1) effective gatekeeping to cardiac catheterization, (2) selective discrimination for revascularization and tailored medical therapy, (3) advanced risk stratification, (4) improvement in outcomes, and (5) support from multisociety guidelines. Given the expansion of CT technologies to include functional strategies for evaluating ischemia both with and without vasodilators, CCTA is poised to become the comprehensive examination for stable chest pain and anginal equivalent cardiopulmonary symptoms.

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Citations

Dec 18, 2018·Journal of Thoracic Imaging·Malcolm AnastasiusJonathan Leipsic
Oct 31, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Stefan BaumannDirk Lossnitzer
Jul 6, 2020·The International Journal of Cardiovascular Imaging·Verena BrandtChristian Tesche
Feb 3, 2021·International Journal of Cardiology·Akos Varga-SzemesAndrew J Buckler
Mar 25, 2020·Journal of Thoracic Imaging·Jiun-Yiing HuCharles S White
Mar 6, 2021·International Journal of Cardiology·Christian TescheVerena Brandt
Jun 5, 2019·Lancet·Evangelos K Oikonomou, Charalambos Antoniades
Jul 24, 2020·Journal of Thoracic Imaging·Pratik S VelangiPrabhjot S Nijjar
Feb 5, 2022·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Prabhakar RajiahPhillip M Young

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