Coronary Computed Tomographic Angiography for Complete Assessment of Coronary Artery Disease: JACC State-of-the-Art Review

Patrick W. Serruys, Hironori Hara, Scot Garg, Hideyuki Kawashima, Bjarne L. Nørgaard, Marc R. Dweck, Jeroen J. Bax, Juhani Knuuti, Koen Nieman, Jonathon A. Leipsic, Saima Mushtaq, Daniele Andreini, Yoshinobu Onuma

Research output: Contribution to journalReview articleAcademicpeer-review

67 Citations (Scopus)

Abstract

Coronary computed tomography angiography (CTA) has shown great technological improvements over the last 2 decades. High accuracy of CTA in detecting significant coronary stenosis has promoted CTA as a substitute for conventional invasive coronary angiography in patients with suspected coronary artery disease. In patients with coronary stenosis, CTA-derived physiological assessment is surrogate for intracoronary pressure and velocity wires, and renders possible decision-making about revascularization solely based on computed tomography. Computed tomography coronary anatomy with functionality assessment could potentially become a first line in diagnosis. Noninvasive imaging assessment of plaque burden and morphology is becoming a valuable substitute for intravascular imaging. Recently, wall shear stress and perivascular inflammation have been introduced. These assessments could support risk management for both primary and secondary cardiovascular prevention. Anatomy, functionality, and plaque composition by CTA tend to replace invasive assessment. Complete CTA assessment could provide a 1-stop-shop for diagnosis, risk management, and decision-making on treatment.
Original languageEnglish
Pages (from-to)713-736
Number of pages24
JournalJournal of the American College of Cardiology
Volume78
Issue number7
DOIs
Publication statusPublished - 17 Aug 2021

Keywords

  • coronary computed tomography angiography
  • coronary physiology
  • coronary plaque

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