ABSTRACT Background and Aims Due to the recent advances in computed tomography coronary angiography (CTCA) technology, it has proved to be an accurate, noninvasive diagnostic substitute for invasive coronary angiography in multiple clinical settings. The aim of the study was to assess the utility of CTCA as an initial diagnostic approach for excluding coronary artery disease, with the goal of alleviating waiting list pressures in a district general hospital. Methods A single‐center, retrospective study enrolling patients with suspected coronary artery disease who underwent CTCA over a 12‐month period from January 1 to December 31, 2022. Electronic patients' medical records and CTCA images and reports from the cardiology and radiology picture archival and communication databases were analyzed to determine major adverse cardiovascular events (MACE) at 1‐year. Results Four hundred and eighty patients were included; the mean age was 59.5. Forty‐five percent were found to have normal coronary arteries, 16.9% had minimal/mild disease, 12.3% had moderate disease, and 13.3% had severe coronary artery disease. 12.5% of the cases were inconclusive. High‐risk plaque features were noted in 1.5% of the cases. Post‐CTCA testing included functional tests in 5.2%, coronary angiogram in 17.5%, functional test plus coronary angiogram in 1.3%, whilst 76% were found to have normal CTCA. Conclusions This study demonstrates that CTCA is a safe and effective way of ruling out coronary artery disease as more than 3/4th of the cases was discharged with normal coronary arteries. Its use in patients with suspected disease not only provides essential diagnostic and risk‐management information but also offers a practical strategy for alleviating waiting list pressures in a district general hospital setting.
Eldesouky et al. (Mon,) studied this question.