Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015;11(4):281-4.
doi: 10.5114/pwki.2015.55597. Epub 2015 Jan 12.

Coronary artery computed tomography as the first-choice imaging diagnostics in patients with high pre-test probability of coronary artery disease (CAT-CAD)

Piotr N Rudziński  1 , Mariusz Kruk  1 , Marcin Demkow  1 , Zofia Dzielińska  1 , Jerzy Pręgowski  2 , Adam Witkowski  2 , Witold Rużyłło  3 , Cezary Kępka  1
Affiliations
Review

Coronary artery computed tomography as the first-choice imaging diagnostics in patients with high pre-test probability of coronary artery disease (CAT-CAD)

Piotr N Rudziński et al. Postepy Kardiol Interwencyjnej. 2015.

Abstract

Introduction: The primary diagnostic examination performed in patients with a high pre-test probability of coronary artery disease (CAD) is invasive coronary angiography. Currently, approximately 50% of all invasive coronary angiographies do not end with percutaneous coronary intervention (PCI) because of the absence of significant coronary artery lesions. It is desirable to eliminate such situations. There is an alternative, non-invasive method useful for exclusion of significant CAD, which is coronary computed tomography angiography (CCTA).

Aim: We hypothesize that use of CCTA as the first choice method in the diagnosis of patients with high pre-test probability of CAD may reduce the number of invasive coronary angiographies not followed by interventional treatment. Coronary computed tomography angiography also seems not to be connected with additional risks and costs of the diagnosis. Confirmation of these assumptions may impact cardiology guidelines.

Material and methods: One hundred and twenty patients with indications for invasive coronary angiography determined by current ESC guidelines regarding stable CAD are randomized 1 : 1 to classic invasive coronary angiography group and the CCTA group.

Results: All patients included in the study are monitored for the occurrence of possible end points during the diagnostic and therapeutic cycle (from the first imaging examination to either complete revascularization or disqualification from the invasive treatment), or during the follow-up period.

Conclusions: Based on the literature, it appears that the use of modern CT systems in patients with high pre-test probability of CAD, as well as appropriate clinical interpretation of the imaging study by invasive cardiologists, enables precise planning of invasive therapeutic procedures. Our randomized study will provide data to verify these assumptions.

Keywords: coronary angiography; coronary artery disease; coronary tomographic angiography; multi-detector computed tomography.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Randomization and further procedures in the CAT-CAD study within the diagnostic and therapeutic cycle (assumed to be complete within 3 months of study entry) CABG – Coronary artery bypass graft, CAD – coronary artery disease, CCTA – coronary computed tomography angiography, FFR – fractional flow reserve, PCI – percutaneous coronary intervention.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Patel MR, Peterson ED, Dai D, et al. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010;362:886–95. - PMC - PubMed
    1. Borges Santos M, Ferreira AM, de Araújo Goncalves P, et al. Diagnostic yield of current referral strategies for elective coronary angiography in suspected coronary artery disease-an analysis of the ACROSS registry. Rev Port Cardiol. 2013;32:483–8. - PubMed
    1. de Araújo Gonçalves P, Jerónimo Sousa P, Calé R, et al. Effective radiation dose of three diagnostic tests in cardiology: single photon emission computed tomography, invasive coronary angiography and cardiac computed tomography angiography. Rev Port Cardiol. 2013;32:981–6. - PubMed
    1. Pregowski J, Kepka C, Kruk M, et al. Comparison of usefulness of percutaneous coronary intervention guided by angiography plus computed tomography versus angiography alone using intravascular ultrasound end points. Am J Cardiol. 2011;108:1728–34. - PubMed
    1. Opolski MP, Kepka C, Witkowski A, et al. Coronary computed tomographic angiography for prediction of procedural and intermediate outcome of bypass grafting to left anterior descending artery occlusion with failed visualization on conventional angiography. Am J Cardiol. 2012;109:1722–8. - PubMed