What is it about?
Coronary CT angiography is increasingly recommended as a first line test in patients with suspected coronary artery disease with low to intermediate risk. It is unknown whether heart MR imaging or myocardial perfusion imaging performs better in patients in which the CT shows coronary artery disease. This randomised controlled trial investigated the diagnostic accuracy of these two functional tests in such a population.
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Why is it important?
NICE guidelines now recommend coronary CT angiography as the first line test in patients with suspected stable coronary artery disease. This randomised trial shows that if the CT shows coronary disease in patients with low to intermediate risk of having relevant coronary artery disease then following functional tests have unexpectedly low diagnostic accuracy with no clear difference between heart MR imaging and myocardial perfusion scintigraphy.
Perspectives
Further research is needed to better understand why the diagnostic accuracy of functional tests is low in patients with abnormal cardiac CT and low to intermediate risk of significant coronary artery disease.
Professor Steffen E Petersen
Queen Mary University of London
Read the Original
This page is a summary of: Diagnosing coronary artery disease after a positive coronary computed tomography angiography: the Dan-NICAD open label, parallel, head to head, randomized controlled diagnostic accuracy trial of cardiovascular magnetic resonance and myocardial perfusio..., European Heart Journal - Cardiovascular Imaging, February 2018, Oxford University Press (OUP),
DOI: 10.1093/ehjci/jex342.
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