Recent Advances in Coronary Computed Tomography Angiogram: The Ultimate Tool for Coronary Artery Disease

The emerging technologies in multidetector computed tomography scanners gave the ability to image coronary arteries in a single heartbeat, at a higher quality, and low radiation dose. Furthermore, incorporating artificial intelligence and machine learning into image processing and interpretation have extended the use for coronary computed tomography angiogram (CCTA) and its applications. In this review, we will explore the recent evidence and advances supporting CCTA to become the ultimate tool for coronary artery disease.

Results from the EVINCI, ISCHEMIA, SCOT-HEART, and PROMISE showed that CCTA is better in patients' risk stratification and in detecting subclinical atherosclerosis, resulting in earlier interventions and lesser events. Additionally, CCTA gave us a closer look on atherosclerotic disease by identifying different type of plaque and their clinical significance. Furthermore, FFR_CT is a notable example of incorporating artificial intelligence into CCTA. This technology helped us to accurately and non-invasively identify flow limiting lesions, guiding revascularization. As a result of the recent evidence, CCTA have made its way into the chest pain guidelines all over the world. Moreover, CCTA have the potential to revolutionize our understanding and standards in screening, preventing, and managing heart disease.