Cardiology Letters 2022, 31(3):165-177

Significance of CT coronary angiography in diagnosis and management of coronary artery disease

Huňavý M¹, Gibarti C², Koribský R², Gonsorčík J³

¹ 1I. kardiologická klinika UPJŠ LF a VÚSCH, a. s., Košice

² Oddelenie rádiológie VÚSCH, a. s., Košice

³ II. kardiologická klinika UPJŠ LF a VÚSCH, a. s., Košice, Slovenská republika

Coronary artery disease is currently a worldwide problem and its prevalence is constantly growing with the ageing of the population, but also due to unhealthy lifestyle habits or inadequate risk factors control. In developed countries it is the leading cause of heart failure. Noninvasive methods of its diagnosis, mainly multidetector computed tomography, has made huge progress in terms of radiation dose reduction, improvement in its diagnostic accuracy, sensitivity and specificity. With technological advances such as CT evaluation of fractional flow reserve and CT myocardial perfusion imaging it is now possible to evaluate functional significance of coronary stenosis during a single exam. Unlike other noninvasive imaging methods, CT coronary angiography shows the most robust evidence regarding prognosis of patients with diagnosed obstructive or nonobstructive coronary artery disease, with subsequent management aimed at primary and secondary prevention, risk factors control and intensification of pharmacotherapy which consists of antiplatelets and hypolipidemic drugs. The greatest benefit of these measures will affect patients with the largest extent of atherosclerotic burden, evaluated by calcium score, plaque volume and by identification of adverse plaque features. The aim of the review article is to point out the current role of CT coronary angiography in diagnosis and management of coronary artery disease, based on the latest guidelines and scientific knowledge.

Keywords: CT coronary angiography; calcium score; stress CT myocardial perfusion

Published: March 1, 2022  Show citation