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Computed tomography angiography in chronic coronary syndrome: Association to catheterization laboratory activity and

Leif Thuesen1, Bjarne Linde Nørgaard2,3, Marc Meller Søndergaard1

  • 1Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.

American Heart Journal Plus : Cardiology Research and Practice
|August 12, 2025
PubMed

Insights

Coronary computed tomography angiography (CCTA) use in chronic coronary syndrome (CCS) patients did not reduce invasive procedures but improved survival rates compared to the general population. This highlights CCTA

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Health Services Research

Background:

  • Chronic coronary syndrome (CCS) management involves invasive coronary angiography (ICA) and revascularization.
  • The introduction of coronary computed tomography angiography (CCTA) aimed to refine diagnostic pathways and improve efficiency.
  • Assessing the impact of CCTA on catheterization laboratory efficiency and patient outcomes is crucial.

Purpose of the Study:

  • To evaluate changes in catheterization laboratory efficiency and all-cause mortality in CCS patients.
  • To compare outcomes before and after the widespread adoption of CCTA.
  • To analyze the relationship between CCTA use, revascularization rates, and survival.

Main Methods:

  • A registry study utilizing data from the Western Denmark Heart Registry (2000-2020).
  • Inclusion of adult patients with suspected CCS undergoing ICA or CCTA.
  • Analysis of revascularization rates (percutaneous coronary intervention/coronary artery bypass grafting), revascularization/ICA ratio, and all-cause mortality.

Main Results:

  • The percentage of revascularized patients decreased significantly with increased CCTA use.
  • The revascularization/ICA ratio showed a slight decrease.
  • Both revascularized and non-revascularized patients demonstrated improved survival compared to the background population, with notable reductions in mortality for those diagnosed via ICA first.

Conclusions:

  • Widespread CCTA use did not decrease the number of ICA procedures without subsequent revascularization.
  • CCTA-first pathways resulted in low rates of subsequent revascularization.
  • Patients diagnosed with CCTA/ICA showed improved survival, potentially due to enhanced prognostication and overall care.
Abstract

Keywords:
Chronic coronary syndromeCoronary arterial bypass graftingCoronary computed tomography angiographyPercutaneous coronary interventionRevascularization

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