Comparative assessment of non-invasive imaging in detecting coronary artery disease

• Coronary artery disease (CAD) has an important impact on the morbidity and mortality in the West and health service resources worldwide. It is therefore crucial to accurately diagnose CAD early, in an attempt to limit its burden on patients and society, potentially by optimum risk stratification, accurate diagnosis and management. Invasive coronary angiography (ICA) is the conventional gold standard imaging investigation for the coronary circulation and assessment of disease severity. However, it is an invasive procedure and is associated with risks, although rare. In addition, it detects luminal stenosis but not the functional importance of those anatomical lesions. Therefore, a wide variety of non-invasive imaging developed to evaluate the presence and severity of CAD, including anatomical techniques e.g. coronary CT that assesses coronary stenosis, and quantifies coronary calcium, hence the burden of atherosclerotic plaques and functional imaging e.g. stress echocardiography, nuclear imaging by SPECT and PET and stress CMR. Selection of the most appropriate imaging, therefore, is challenging and requires knowledge of patients' pre-test probability and prevalence of disease, their advantages and limitations, cost and availability. This review attempts to provide an overview of the current supporting evidence of the role of non-invasive imaging in diagnosing CAD, in addition to its prognostic value, limitations and advantages.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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