Coronary CTA Compares Well With Invasive Cath in High-Risk Patients

Objective: To evaluate coronary CT angiography (CTA) for therapeutic decision making in patients with a high pretest probability of coronary artery disease (CAD). Design: Prospective study. Participants: 185 patients who presented with either stable angina or atypical chest pain and had been referred for elective invasive cardiac catheterization were included. All patients had a recent positive SPECT myocardial perfusion study with a summed stress score ≥9. Methods: All patients underwent CTA with either a first- or second-generation dual-source CT scanner. Sublingual nitroglycerin was given and β-blockers were given as needed to lower heart rates to Results: 42 of 185 (23%) patients did not have CAD and 113 of 185 (61%) patients did not get subsequent revascularization. In 178 of 185 (96%) patients, the same therapeutic strategy was chosen by evaluating the coronary CTA findings alone with SPECT compared with conventional invasive cardiac catheterization with SPECT. No patie more...