Coronary CT Angiography in Coronary Artery Disease: from Diagnosis to Prevention.
There is a growing body of evidence supporting the fact that Coronary CT Angiography (CCTA) is a well-established imaging modality in the diagnosis of Coronary Artery Disease (CAD) due to its less invasiveness, high diagnostic value, and widespread accessibility.
This is clinically important as unnecessary invasive coronary angiography or other examinations can be avoided in patients with a normal CCTA. Findings of CCTA are closely related to the clinical outcomes with very low rate of adverse cardiac events occurring in patients with normal CCTA, but with significantly high rates of these events in patients with obstructive CAD.
According to several systematic reviews and meta-analyses of 64-slice CCTA studies in the diagnosis of CAD, the sensitivities were more than 97% and specificities were more than 87% in most of the studies. These analyses indicate that CCTA has high diagnostic value in the detection and characterization of CAD due to presence of plaques.
Four systematic reviews and meta-analyses of studies on the use of prospectively ECG-triggered 64-or more slice CCTA reported that the mean patient-based sensitivities and specificities ranged from 99% to 100%, and 89% to 92%, respectively, which is similar to those reported with use of retrospectively ECG-gated CCTA, but with resultant much lower radiation dose.18,19,38,39 Table 1 summarizes the diagnostic value of these systematic reviews and meta-analyses of studies performed with CCTA in CAD.
CCTA can detect non-obstructive and noncalcified plaques as well as plaques with positive remodeling, both of which play an important role in the pathophysiology of acute myocardial infarction and may be indicative of vulnerable plaques.
Heart Res Open J . 2014; 1(1): 1-9. doi: 10.17140/HROJ-1-101
