The Role of Computed Tomographic Coronary Angiography in the Diagnosis of Coronary Artery Disease

Several modalities are available for determining the presence and extent of suspected coronary artery disease (CAD). To assess the optimal use of computed tomographic coronary angiography (CTCA) relative to stress testing and invasive coronary angiography (ICA), investigators conducted a prospective study involving 517 patients referred to a single center in the Netherlands for evaluation of chest symptoms.

The investigators used the Duke clinical score to classify patients' pretest probability of having CAD as low (<20%), intermediate (20%–80%), or high (>80%). All patients underwent both CTCA and stress testing. One hundred forty-one patients had both a negative stress test result and a normal CTCA result and were not referred for ICA. Com…