Coronary computed tomography angiography versus stress testing in suspected coronary disease

Abstract

The position of functional testing as the cornerstone of the non-invasive evaluation of patients with suspected coronary artery disease is currently being challenged by the emergence of non-invasive coronary angiography using computed tomography. Stress testing and cardiac computed tomography assess related but different aspects of ischemic heart disease, and therefore provide complementary diagnostic, and sometimes conflicting prognostic, information. While assessment of inducible ischemia is important for clinical decision making, computed tomography allows more confident exclusion of obstructive coronary artery disease in low–intermediate-risk patients. For which patient, and which situation, either modality is most useful will need to be determined in prospective clinical trials.

Keywords::

• atherosclerosis
• computed tomography
• coronary angiography
• coronary artery disease
• coronary calcium
• myocardial ischemia
• stress testing

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.