Computed tomography of coronary artery atherosclerosis: A review

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Coronary artery disease (CAD) is a leading cause of mortality in the US.
• Non-invasive methods are crucial for primary prevention in asymptomatic individuals.
• Accurate detection of atherosclerosis is vital for patient management.

Purpose of the Study:

• To evaluate the diagnostic performance of Coronary Computed Tomographic Angiography (CCTA).
• To assess the role of CCTA in managing patients with suspected or existing coronary artery disease.
• To highlight the predictive value of CCTA in long-term outcomes.

Main Methods:

• Review of CCTA's capabilities in detecting coronary artery plaque and stenosis.
• Analysis of negative predictive value and long-term follow-up data post-CCTA.
• Discussion of CCTA's application in various clinical scenarios, including acute chest pain and stable angina.

Main Results:

• CCTA demonstrates excellent accuracy in identifying coronary artery plaque and stenosis.
• A negative CCTA is associated with a very low incidence of future adverse coronary events.
• CCTA-based management improves outcomes in stable angina and aids emergency department triage.

Conclusions:

• CCTA is a powerful non-invasive tool for diagnosing and excluding coronary artery disease.
• Its high negative predictive value supports its use for primary prevention and risk stratification.
• Emerging CT techniques like CT perfusion and CT-FFR show promise for assessing stenosis significance.