Coronary CT angiography

Overview

Unverified · drafted by AI from the sources cited below

Definition

Coronary computed tomography angiography (CTA) is a non-invasive imaging method that uses a CT scanner and contrast material to capture detailed images of the coronary vessels, which are the veins and arteries of the heart.12 CTA has experienced significant technological improvements over the last 2 decades and is used to detect significant coronary stenosis as a substitute for conventional invasive coronary angiography in patients with suspected coronary artery disease.3 Additionally, computed tomography coronary anatomy with functionality assessment has the potential to become a first line in diagnosis.3

Diagnosis and risk stratification

CTA has shown high accuracy in detecting significant coronary stenosis and can serve as a substitute for conventional invasive coronary angiography in patients with suspected coronary artery disease.1 In patients with coronary stenosis, CTA-derived physiological assessment serves as a surrogate for intracoronary pressure and velocity wires.1 Noninvasive imaging assessment of plaque burden and morphology is becoming a valuable substitute for intravascular imaging, and assessments of wall shear stress and perivascular inflammation have recently been introduced to support risk management.1 Furthermore, elevated lipoprotein(a) and coronary artery calcium scores are individually associated with increased atherosclerotic cardiovascular disease risk.2 Parallel improvements in coronary imaging modalities can assess plaque volumes and composition using noninvasive techniques.3

Treatment

CTA renders possible decision-making about revascularization solely based on computed tomography.1 Complete CTA assessment could provide a 1-stop-shop for diagnosis, risk management, and decision-making on treatment.1 Many studies have longitudinally assessed changes in plaque characteristics in response to various treatments, aiming to demonstrate plaque regression and improvements in high-risk features.2 Furthermore, angiography remains the most widely used method to guide percutaneous coronary intervention (PCI), as studied in FAVOR III China, which assessed clinical outcomes using the quantitative flow ratio for PCI selection.3

New research on Coronary CT angiography

15 O‐water PET‐detected myocardial ischaemia and CT‐derived FFR: Predicting the functional significance of anatomical stenosis

Clinical Physiology and Functional Imaging — J V — Oct 2026

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Bilateral peripheral CT venography for evaluating central venous lesions in dysfunctional arteriovenous fistulas: feasibility, safety, and radiation dose in hemodialysis patients

Renal Failure — 张宏伟 — Oct 2026

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Intracerebral Hemorrhage Expansion in Late Presenters

Neurology — Morotti A — Oct 2026

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Ultrasound-based multimodal diagnosis and endovascular therapy for phlegmasia cerulea dolens secondary to May–Thurner syndrome in a middle-aged male patient

Journal clubs discussing Coronary CT angiography

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#bruinhearts CCU Journal Club: ISCHEMIA trial

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Key papers

Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China): a multicentre, randomised, sham-controlled trial

The Lancet

429 citations · 2021 · among the most cited on Coronary CT angiography

Coronary Computed Tomographic Angiography for Complete Assessment of Coronary Artery Disease

Journal of the American College of Cardiology — Serruys P

208 citations · 2021 · among the most cited on Coronary CT angiography

Coronary Atherosclerotic Plaque Regression

Journal of the American College of Cardiology — Dawson L

197 citations · 2022 · among the most cited on Coronary CT angiography

Eruptive Calcified Nodules as a Potential Mechanism of Acute Coronary Thrombosis and Sudden Death

Journal of the American College of Cardiology — Torii S

180 citations · 2021 · among the most cited on Coronary CT angiography

How this page is built

A clinical question appears here only when its condition matches this topic, an outcome and a comparator were extracted from the studies, at least two studies and a patient count are on file, and the certainty is low or higher.

Supports benefit, no benefit shown, and mixed describe the direction of the measured effect. No benefit shown means the evidence does not support a benefit. It is not a finding of harm. Too little evidence means the question did not clear that bar.

Study count, RCT count, and patient count are separate. The patient total adds only studies that are linked into a study family and whose sample size is not flagged as implausible. A reversal is listed only when at least one randomized trial sits on each side of the change.

The overview is drafted from the guideline recommendations, trials, papers, and questions on this page, and every sentence has to cite one of them. It stays unverified until an NPI-verified clinician or a Synapse admin approves it. Approving records that person's name.