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Clinical perspective of coronary computed tomographic angiography in diagnosis of coronary artery disease

Authors
 Hyuk-Jae Chang  ;  Namsik Chung 
Citation
 CIRCULATION JOURNAL, Vol.75(2) : 246-252, 2011 
Journal Title
 CIRCULATION JOURNAL 
ISSN
 1346-9843 
Issue Date
2011
MeSH
Acute Disease ; Algorithms ; Asymptomatic Diseases ; Calcinosis/diagnostic imaging ; Calcinosis/pathology ; Chest Pain/diagnostic imaging ; Clinical Trials as Topic/statistics & numerical data ; Contrast Media ; Coronary Disease/diagnostic imaging* ; Electrocardiography ; Emergency Service, Hospital ; Forecasting ; Humans ; Mass Screening ; Multicenter Studies as Topic/statistics & numerical data ; Plaque, Atherosclerotic/diagnostic imaging ; Plaque, Atherosclerotic/pathology ; Predictive Value of Tests ; Radiation Dosage ; Risk Assessment ; Tomography, Spiral Computed*/adverse effects ; Tomography, Spiral Computed*/economics ; Tomography, Spiral Computed*/methods
Keywords
Coronary artery disease ; Coronary CT angiography ; Prognosis
Abstract
Since a 4-detector row coronary computed tomographic angiography (CCTA) was launched in 1998, CCTA has experienced rapid improvement of imaging qualities with the ongoing evolution of computed tomography (CT) technology. The diagnostic accuracy of CCTA to detect coronary artery stenosis is well established, whereas improvements are still needed to reduce the overestimation of coronary artery disease (CAD) and assess plaque composition. CCTA has been used to evaluate CAD in various clinical settings. For example, CCTA could be an efficient initial triage tool at emergency departments for patients with acute chest pain with low-to-intermediate risk because of its high negative predictive value. In patients with suspected CAD, CCTA could be a cost-effective alternative to myocardial perfusion imaging and exercise electrocardiogram for the initial coronary evaluation of patients with intermediate pre-test likelihood suspected CAD. However, in asymptomatic populations, there is a lack of studies that show an improved prognostic power of CCTA over other modalities. Therefore, the clinical use of CCTA to detect CAD for purposes of risk stratification in asymptomatic individuals should be discouraged. As CT technology evolves, CCTA will provide better quality coronary imaging and non-coronary information with lower radiation exposure. Future studies should cover these ongoing technical improvements and evaluate the prognostic power of CCTA in various clinical settings of CAD in large, well-designed, randomized trials.
Files in This Item:
T201100573.pdf Download
DOI
10.1253/circj.CJ-10-1206
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92783
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