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Finding the gatekeeper to the cardiac catheterization laboratory: coronary CT angiography or stress testing?


Marwick, TH and Cho, I and O Hartaigh, B and Min, JK, Finding the gatekeeper to the cardiac catheterization laboratory: coronary CT angiography or stress testing?, Journal of the American College of Cardiology, 65, (25) pp. 2747-2756. ISSN 0735-1097 (2015) [Refereed Article]

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DOI: doi:10.1016/j.jacc.2015.04.060


Functional capacity is a robust predictor of clinical outcomes, and stress testing is used in current practice paradigms to guide referral to invasive coronary angiography. However, invasive coronary angiography is driven by ongoing symptoms, as well as risk of adverse outcomes. The limitations of current functional testing-based paradigms might be avoided by using coronary computed tomographic angiography (CCTA) for exclusion of obstructive coronary artery disease. The growth of CCTA has been supported by comparative prognostic evidence with CCTA and functional testing, as well as radiation dose reduction. Use of CCTA for physiological evaluation of coronary lesion-specific ischemia may facilitate evaluation of moderate stenoses, designation of the culprit lesion, and prediction of benefit from revascularization. The potential of CCTA to serve as an effective gatekeeper to invasive coronary angiography will depend, in part, on the adoption of these new developments, as well as definition of the benefit of detecting high-risk plaque for guiding the management of selected patients.

Item Details

Item Type:Refereed Article
Keywords:angina, atherosclerotic, cardiac catheterization, chest pain, coronary artery disease, coronary computed tomography, plaque
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:101893
Year Published:2015
Web of Science® Times Cited:37
Deposited By:Menzies Institute for Medical Research
Deposited On:2015-07-16
Last Modified:2017-11-02

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