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Updated: Jun 20, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
[Cardiac computer tomography in the investigation of atypical chest pain]
Kristian Altern Ovrehus1, Jesper Khédri Jensen, Jesper Møller Jensen
1Hjertemedicinske Afdeling, Vejle Sygehus, DK-7100 Vejle. kristianovrehus@hotmail.com.
Insights
Coronary CT angiography (CTA) effectively excludes coronary artery disease (CAD) in 46% of patients. This diagnostic tool reduces the need for further testing and hospital follow-up in 73% of cases, preventing unnecessary invasive procedures.
Area of Science:
- Cardiovascular Imaging
- Diagnostic Radiology
Context:
- Coronary CT angiography (CTA) is increasingly utilized for diagnosing coronary artery disease (CAD).
- Limited data exists on the diagnostic and therapeutic impact of CTA in clinical practice.
- Patients with chest pain and intermediate pre-test probability for CAD were evaluated.
Purpose:
- To assess the diagnostic yield and clinical consequences of using CTA in patients with suspected CAD.
- To determine the rate of CAD exclusion and the necessity of further diagnostic work-up post-CTA.
Summary:
- CTA was diagnostic in 88% of 215 outpatients with suspected CAD.
- CTA excluded CAD in 46% and identified significant CAD in 15% of patients.
- No further diagnostic testing or hospital follow-up was needed for 73% of patients post-CTA.
Impact:
- CTA demonstrates significant value in ruling out CAD, potentially avoiding unnecessary invasive coronary angiography.
- The findings support CTA as an effective tool for streamlining the diagnostic pathway in suspected CAD.
- Increased use of antithrombotic and lipid-lowering medications suggests appropriate management adjustments post-CTA.
Introduction:
Coronary CT angiography (CTA) is a promising method used for diagnostic evaluation of patients suspected of coronary artery disease (CAD). CTA is increasingly used as an alternative to conventional coronary angiography. Information on the diagnostic and therapeutic consequences of using CTA in the diagnostic work-up of patients suspected of CAD is sparse.
Material And Methods:
Out-clinic patients (n = 215) with chest pain and an intermediate pre-test probability of CAD were referred to diagnostic evaluation by CTA.
Results:
CTA was not performed in 5% (11/215) due to extensive coronary calcification or arrhythmia, was non-conclusive in 7% (15/215) and was diagnostic in 88% (189/215) of the patients. CTA excluded CAD in 46% (99/215) of the patients. No further diagnostic or hospital follow-up after CTA was necessary in 73% (156/215) of the patients. CTA identified non-significant CAD in 27% (57/215) and significant CAD (>or= 50% stenosis) in 15% (33/215) of the patients. The proportion of patients with CAD in relevant antithrombotic and lipid-lowering medication increased following CTA. Further diagnostic evaluation with coronary angiography following CTA was indicated in 18% (39/215) of the patients due to obstructive CAD (n = 21), non-diagnostic examination (n = 7), or the presence of extensive coronary calcification or arrhythmia (n = 11).
Conclusion:
CTA ruled-out CAD in 46% of the patients. No further diagnostic testing or hospital follow-up after CTA was necessary in 73% of the patients. CTA seems valuable in excluding CAD, and may prevent unnecessary invasive angiography in patients without CAD.
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