The Emerging Roles of Coronary Computed Tomographic Angiography: Acute Chest Pain Evaluation and Screening for Asymptomatic Individuals

Overview

Journal Acta Cardiol Sin

Date 2016 Apr 29

PMID 27122947

Citations 2

Authors

Ning Chien

Tzung-Dau Wang

Yeun-Chung Chang

Po-Chih Lin

Yao-Hui Tseng

Yee-Fan Lee

Wei-Chun Ko

Bai-Chin Lee

Wen-Jeng Lee

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Coronary computed tomographic angiography (CCTA) has been widely available since 2004. After that, the diagnostic accuracy of CCTA has been extensively validated with invasive coronary angiography for detection of coronary arterial stenosis. In this paper, we reviewed the updated evidence of the role of CCTA in both scenarios including acute chest pain and screening in asymptomatic adults. Several large-scale studies have been conducted to evaluate the diagnostic value of CCTA in the context of acute chest pain patients. CCTA could play a role in delivering more efficient care. For risk stratification of asymptomatic patients using CCTA, latest studies have revealed incremental benefits. Future studies evaluating the totality of plaque characteristics may be useful for determining the role of noncalcified plaque for risk stratification in asymptomatic individuals.

Key Words: Acute chest pain • Computed tomography • Coronary artery disease • Health screening • Stable angina.

Citing Articles

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References

Choi E, Choi S, Rivera J, Nasir K, Chang S, Chun E . Coronary computed tomography angiography as a screening tool for the detection of occult coronary artery disease in asymptomatic individuals. J Am Coll Cardiol. 2008; 52(5):357-65. DOI: 10.1016/j.jacc.2008.02.086. View

Sandfort V, Lima J, Bluemke D . Noninvasive Imaging of Atherosclerotic Plaque Progression: Status of Coronary Computed Tomography Angiography. Circ Cardiovasc Imaging. 2015; 8(7):e003316. PMC: 4499869. DOI: 10.1161/CIRCIMAGING.115.003316. View

Meijboom W, Meijs M, Schuijf J, Cramer M, Mollet N, van Mieghem C . Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol. 2008; 52(25):2135-44. DOI: 10.1016/j.jacc.2008.08.058. View

Hausleiter J, Meyer T, Hermann F, Hadamitzky M, Krebs M, Gerber T . Estimated radiation dose associated with cardiac CT angiography. JAMA. 2009; 301(5):500-7. DOI: 10.1001/jama.2009.54. View

Detrano R, Guerci A, Carr J, Bild D, Burke G, Folsom A . Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med. 2008; 358(13):1336-45. DOI: 10.1056/NEJMoa072100. View

Cho I, Chang H, Sung J, Pencina M, Lin F, Dunning A . Coronary computed tomographic angiography and risk of all-cause mortality and nonfatal myocardial infarction in subjects without chest pain syndrome from the CONFIRM Registry (coronary CT angiography evaluation for clinical outcomes: an.... Circulation. 2012; 126(3):304-13. DOI: 10.1161/CIRCULATIONAHA.111.081380. View

Litt H, Gatsonis C, Snyder B, Singh H, Miller C, Entrikin D . CT angiography for safe discharge of patients with possible acute coronary syndromes. N Engl J Med. 2012; 366(15):1393-403. DOI: 10.1056/NEJMoa1201163. View

Budoff M, Dowe D, Jollis J, Gitter M, Sutherland J, Halamert E . Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment.... J Am Coll Cardiol. 2008; 52(21):1724-32. DOI: 10.1016/j.jacc.2008.07.031. View

Chen M, Steigner M, Leung S, Kumamaru K, Schultz K, Mather R . Simulated 50 % radiation dose reduction in coronary CT angiography using adaptive iterative dose reduction in three-dimensions (AIDR3D). Int J Cardiovasc Imaging. 2013; 29(5):1167-75. PMC: 3701132. DOI: 10.1007/s10554-013-0190-1. View

10.

Bluemke D, Achenbach S, Budoff M, Gerber T, Gersh B, Hillis L . Noninvasive coronary artery imaging: magnetic resonance angiography and multidetector computed tomography angiography: a scientific statement from the american heart association committee on cardiovascular imaging and intervention of the council on.... Circulation. 2008; 118(5):586-606. DOI: 10.1161/CIRCULATIONAHA.108.189695. View

11.

Versteylen M, Kietselaer B, Dagnelie P, Joosen I, Dedic A, Raaijmakers R . Additive value of semiautomated quantification of coronary artery disease using cardiac computed tomographic angiography to predict future acute coronary syndrome. J Am Coll Cardiol. 2013; 61(22):2296-305. DOI: 10.1016/j.jacc.2013.02.065. View

12.

Bachar G, Atar E, Fuchs S, Dror D, Kornowski R . Prevalence and clinical predictors of atherosclerotic coronary artery disease in asymptomatic patients undergoing coronary multidetector computed tomography. Coron Artery Dis. 2007; 18(5):353-60. DOI: 10.1097/MCA.0b013e3281286529. View

13.

Pflederer T, Marwan M, Schepis T, Ropers D, Seltmann M, Muschiol G . Characterization of culprit lesions in acute coronary syndromes using coronary dual-source CT angiography. Atherosclerosis. 2010; 211(2):437-44. DOI: 10.1016/j.atherosclerosis.2010.02.001. View

14.

Hoffmann U, Bamberg F, Chae C, Nichols J, Rogers I, Seneviratne S . Coronary computed tomography angiography for early triage of patients with acute chest pain: the ROMICAT (Rule Out Myocardial Infarction using Computer Assisted Tomography) trial. J Am Coll Cardiol. 2009; 53(18):1642-50. PMC: 2747766. DOI: 10.1016/j.jacc.2009.01.052. View

15.

Hoffmann U, Truong Q, Schoenfeld D, Chou E, Woodard P, Nagurney J . Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med. 2012; 367(4):299-308. PMC: 3662217. DOI: 10.1056/NEJMoa1201161. View

16.

DAscenzo F, Cerrato E, Biondi-Zoccai G, Omede P, Sciuto F, Presutti D . Coronary computed tomographic angiography for detection of coronary artery disease in patients presenting to the emergency department with chest pain: a meta-analysis of randomized clinical trials. Eur Heart J Cardiovasc Imaging. 2012; 14(8):782-9. DOI: 10.1093/ehjci/jes287. View

17.

Min J, Kang N, Shaw L, Devereux R, Robinson M, Lin F . Costs and clinical outcomes after coronary multidetector CT angiography in patients without known coronary artery disease: comparison to myocardial perfusion SPECT. Radiology. 2008; 249(1):62-70. DOI: 10.1148/radiol.2483071453. View

18.

Rivera J, Nasir K, Choi E, Yoon Y, Chun E, Choi S . Detection of occult coronary artery disease in asymptomatic individuals with diabetes mellitus using non-invasive cardiac angiography. Atherosclerosis. 2008; 203(2):442-8. DOI: 10.1016/j.atherosclerosis.2008.07.030. View

19.

Romeo F, Leo R, Clementi F, Razzini C, Borzi M, Martuscelli E . Multislice computed tomography in an asymptomatic high-risk population. Am J Cardiol. 2007; 99(3):325-8. DOI: 10.1016/j.amjcard.2006.08.029. View

20.

Hadamitzky M, Meyer T, Hein F, Bischoff B, Martinoff S, Schomig A . Prognostic value of coronary computed tomographic angiography in asymptomatic patients. Am J Cardiol. 2010; 105(12):1746-51. DOI: 10.1016/j.amjcard.2010.01.354. View