Coronary Computed Tomography Angiography From Clinical Uses to Emerging Technologies: JACC State-of-the-Art Review

J Am Coll Cardiol. 2020 Sep 8;76(10):1226-1243. doi: 10.1016/j.jacc.2020.06.076.

Abstract

Evaluation of coronary artery disease (CAD) using coronary computed tomography angiography (CCTA) has seen a paradigm shift in the last decade. Evidence increasingly supports the clinical utility of CCTA across various stages of CAD, from the detection of early subclinical disease to the assessment of acute chest pain. Additionally, CCTA can be used to noninvasively quantify plaque burden and identify high-risk plaque, aiding in diagnosis, prognosis, and treatment. This is especially important in the evaluation of CAD in immune-driven conditions with increased cardiovascular disease prevalence. Emerging applications of CCTA based on hemodynamic indices and plaque characterization may provide personalized risk assessment, affect disease detection, and further guide therapy. This review provides an update on the evidence, clinical applications, and emerging technologies surrounding CCTA as highlighted at the 2019 National Heart, Lung and Blood Institute CCTA Summit.

Keywords: atherosclerosis; coronary artery disease; coronary computed tomography angiography.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Biomedical Technology / trends*
  • Chest Pain / diagnostic imaging
  • Chest Pain / etiology
  • Computed Tomography Angiography / methods
  • Computed Tomography Angiography / trends*
  • Coronary Angiography / methods
  • Coronary Angiography / trends*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnostic imaging*
  • Humans
  • Review Literature as Topic
  • Risk Assessment / methods
  • Risk Assessment / trends
  • Vascular Calcification / complications
  • Vascular Calcification / diagnostic imaging