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

journal contribution
posted on 2023-05-18, 11:48 authored by Thomas MarwickThomas Marwick, Cho, I, O Hartaigh, B, Min, JK
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.

History

Publication title

Journal of the American College of Cardiology

Volume

65

Issue

25

Pagination

2747-2756

ISSN

0735-1097

Department/School

Menzies Institute for Medical Research

Publisher

Elsevier Science Inc

Place of publication

360 Park Ave South, New York, USA, Ny, 10010-1710

Rights statement

© 2015 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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