Abstract
Coronary CT angiography (CTA) has rapidly evolved into a useful tool in the arsenal of cardiac imaging tests available to clinicians. Technologic advances in coronary CTA have made it possible to image the coronary vasculature with excellent accuracy for defining the presence and severity of luminal stenoses, especially in low-to-intermediate risk persons. In recent years, the prognostic value of coronary CTA has been reported in multiple studies. This is now the fastest-growing application of CT scanners in the United States; ∼500,000 Americans undergo coronary CTA each year. What remains to be seen is its place among other traditional and time-tested diagnostic modalities for coronary artery disease (CAD), such as stress testing. Despite its widely embraced enthusiasm, the value of coronary CTA as an alternative to stress testing has not been established, particularly among patients with chronic stable angina. Because of its high sensitivity and negative predictive value, coronary CTA has been particularly useful in “ruling out” CAD in patients with acute chest pain who present to the emergency department. In this setting, coronary CTA may indeed be a better alternative to stress testing, with reduced overall costs and resource utilization in low-to-intermediate risk patients. 1 Goldstein J.A. Chinnaiyan K.M. Abidov A. Achenbach S. Berman D.S. Hayes S.W. Hoffmann U. Lesser J.R. Mikati I.A. O'Neil B.J. Shaw L.J. Shen M.Y. Valeti U.S. Raff G.L. CT-STAT Investigators: The CT-STAT (Coronary Computed Tomographic Angiography for Systematic Triage of Acute Chest Pain Patients to Treatment) trial. J Am Coll Cardiol. 2011; 58: 1414-1422 Abstract Full Text Full Text PDF PubMed Scopus (448) Google Scholar , 2 Goldstein J.A. Gallagher M.J. O'Neill W.W. Ross M.A. O'Neil B.J. Raff G.L. A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain. J Am Coll Cardiol. 2007; 49: 863-871 Abstract Full Text Full Text PDF PubMed Scopus (529) Google Scholar , 3 Ladapo J.A. Jaffer F.A. Hoffmann U. Thomson C.C. Bamberg F. Dec W. Cutler D.M. Weinstein M.C. Gazelle G.S. Clinical outcomes and cost-effectiveness of coronary computed tomography angiography in the evaluation of patients with chest pain. J Am Coll Cardiol. 2009; 54: 2409-2422 Abstract Full Text Full Text PDF PubMed Scopus (78) Google Scholar In patients with chronic stable angina, however, the performance of coronary CTA in comparison with stress testing remains unclear.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
