Computed tomography coronary angiography – past, present and future

Cardiovascular disease (CVD) is the leading cause of death globally. Data from the World Health Organization shows that an estimated 17.7 million people died from CVD in 2015, representing 31% of all global deaths. Of these deaths, an estimated 7.4 million were due to coronary heart disease. The Singapore Heart Foundation estimates that 16 people die from CVD every day in Singapore. In 2016, CVDs accounted for 29.5% of all deaths in Singapore. nvasive coronary angiography (ICA) is the gold standard for evaluation of the coronary artery lumen, in view of its high spatial and temporal resolution. In the last three decades, computed tomography coronary angiography (CTCA) has emerged as a robust and reliable non-invasive imaging modality for the assessment of coronary artery disease (CAD). The high negative predictive value of normal CTCA images can effectively exclude significant CAD, thereby avoiding the need for further imaging tests and reducing the need for ICA as the first-line investigation in patients with low to intermediate risk of CAD. n this review, we discuss the evolution of CTCA and review the current and future applications of CTCA in the assessment of CAD.