Cardiac Computed Tomography Angiography in the Evaluation of Coronary Artery Disease: An Interventional Perspective

Cardiac computed tomography angiography (CCTA) has become the gold standard for noninvasive anatomic assessment of the coronary arteries. With high positive predictive value and even higher negative predictive value, CCTA allows for rapid determination of the presence or absence of coronary plaque and triage of patients' need for further invasive evaluation and treatment. From an interventional cardiologist's perspective, CCTA (more so than stress testing) is helpful in determining the need for invasive therapy. In conjunction with functional assessments, the anatomic evaluation from CCTA mirrors the anatomical assessment of a coronary angiogram more than any other noninvasive assessment. This allows for catheter selection, percutaneous coronary intervention preplanning, as well as additional decision making before the patient has entered the catheterization laboratory. This manuscript explores some of the more recent developments in noninvasive coronary angiography and discusses the use and utility of CCTA from an interventional cardiologist's perspective.