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Current Cardiovascular Imaging Reports

, 10:15

Topical Collection on Cardiac Computed Tomography


Purpose of ReviewCost-effective care pathways are integral to delivering sustainable healthcare programmes. Due to the overestimation of coronary artery disease using traditional risk tables, non-invasive testing has been utilised to improve risk stratification and initiate appropriate management to reduce the dependence on invasive investigations. In line with recent technological improvements, cardiac CT is a modality that offers a detailed anatomical assessment of coronary artery disease comparable to invasive coronary angiography.

Recent FindingsThe recent publication of the National Institute for Health and Care Excellences NICE Clinical Guideline 95 update assesses the performance and cost utility of different non-invasive imaging strategies in patients presenting with suspected anginal chest pain. The low cost and high sensitivity of cardiac CT makes it the non-invasive test of choice in the evaluation of stable angina. This has now been ratified in national guidelines with NICE recommending cardiac CT as the first-line investigation for all patients presenting with chest pain due to suspected coronary artery disease. Additionally, randomised controlled trials have demonstrated that cardiac CT improves diagnostic certainty when incorporated into chest pain pathways.

SummaryNICE recommend cardiac CT as the first-line test for the evaluation of stable coronary artery disease in chest pain pathways.

KeywordsCoronary computed tomography angiography Chest pain Angina Coronary artery disease AbbreviationsCACSCoronary artery calcium score

CADCoronary artery disease

CTCAComputed tomography coronary angiography

CMRCardiac magnetic resonance

DSEDobutamine stress echocardiography


ExSEExercise stress echocardiography

ICAinvasive coronary angiography

MIMyocardial infarction

MPS–SPECTMyocardial perfusion scintigraphy–single positron emission computed tomography

NHSNational Health Service

NICENational Institute for Health and Care Excellence

PTLPre-Test likelihood

This article is part of the Topical Collection on Cardiac Computed Tomography

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Autor: Alastair J. Moss - Michelle C. Williams - David E. Newby - Edward D. Nicol


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