Coronary computed tomography angiography in patients with stable coronary artery disease

David I. Feldman, Jacqueline Latina, Jana Lovell, Roger S. Blumenthal, Armin Arbab-Zadeh

Research output: Contribution to journalReview articlepeer-review

Abstract

The treatment of coronary artery disease (CAD), which is defined by stable anatomical atherosclerotic and functional alterations of epicardial vessels or microcirculation, focuses on managing intermittent angina symptoms and preventing major adverse cardiovascular events with optimal medical therapy. When patients with known CAD present with angina and no acute coronary syndrome, they have historically been evaluated with a variety of noninvasive stress tests that utilize electrocardiography, radionuclide scintigraphy, echocardiography, or magnetic resonance imaging for determining the presence and extent of inducible myocardial ischemia. Patient event-free survival, however, is largely driven by the coronary atherosclerotic disease burden, which is not directly assessed by functional testing. Direct evaluation of coronary atherosclerotic disease by coronary computed tomography angiography (coronary CTA) has emerged as the first line noninvasive imaging modality as it improves diagnostic accuracy and positively influences clinical management. Compared to functional assessment of CAD, coronary CTA-guided management results in improved patient outcomes by facilitating prevention of myocardial infarction. Other strengths of coronary CTA include detailed atherosclerotic plaque characterization and the ability to assess functional significance of specific lesions, which may further improve risk assessment and prognosis and lead to more appropriate referrals for additional testing, such as invasive coronary angiography.

Original languageEnglish (US)
JournalTrends in Cardiovascular Medicine
DOIs
StatePublished - Oct 2022

Keywords

  • Cardiovascular disease prevention
  • Coronary artery disease
  • Coronary computed tomography angiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Coronary computed tomography angiography in patients with stable coronary artery disease'. Together they form a unique fingerprint.

Cite this