Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm

Diagnosis and management of coronary artery disease represents major challenges to our health care system, affecting millions of patients each year. Until recently, the diagnosis of coronary artery disease was possible only through cardiac catheterization and invasive coronary angiography. To avoid...

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Main Author: Armin Arbab-Zadeh
Format: Article
Language:English
Published: Touch Medical Media 2012-02-01
Series:Heart International
Subjects:
Online Access:http://www.pagepress.org/journals/index.php/hi/article/view/4055
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author Armin Arbab-Zadeh
author_facet Armin Arbab-Zadeh
author_sort Armin Arbab-Zadeh
collection DOAJ
description Diagnosis and management of coronary artery disease represents major challenges to our health care system, affecting millions of patients each year. Until recently, the diagnosis of coronary artery disease was possible only through cardiac catheterization and invasive coronary angiography. To avoid the risks of an invasive procedure, stress testing is often employed for an initial assessment of patients with suspected coronary artery disease, serving as a gatekeeper for cardiac catheterization. With the emergence of noninvasive coronary angiography, the question arises if such a strategy is still sensible, particularly, in view of only a modest agreement between stress testing results and the presence of coronary artery disease established by cardiac catheterization. Much data in support of the diagnostic accuracy and prognostic value of non-invasive coronary angiography by computed tomography have emerged within the last few years. These data challenge the role of stress testing as the initial imaging modality in patients with suspected coronary artery disease. This article reviews the clinical utility, limitations, as well as the hazards of stress testing compared with non-invasive coronary artery imaging by computed tomography. Finally, the implications of this review are discussed in relation to clinical practice
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spelling doaj.art-cd56b347078b4eb988985aa7cbeb7ce42022-12-21T19:48:22ZengTouch Medical MediaHeart International1826-18682036-25792012-02-0171e2e210.4081/hi.2012.e2Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigmArmin Arbab-ZadehDiagnosis and management of coronary artery disease represents major challenges to our health care system, affecting millions of patients each year. Until recently, the diagnosis of coronary artery disease was possible only through cardiac catheterization and invasive coronary angiography. To avoid the risks of an invasive procedure, stress testing is often employed for an initial assessment of patients with suspected coronary artery disease, serving as a gatekeeper for cardiac catheterization. With the emergence of noninvasive coronary angiography, the question arises if such a strategy is still sensible, particularly, in view of only a modest agreement between stress testing results and the presence of coronary artery disease established by cardiac catheterization. Much data in support of the diagnostic accuracy and prognostic value of non-invasive coronary angiography by computed tomography have emerged within the last few years. These data challenge the role of stress testing as the initial imaging modality in patients with suspected coronary artery disease. This article reviews the clinical utility, limitations, as well as the hazards of stress testing compared with non-invasive coronary artery imaging by computed tomography. Finally, the implications of this review are discussed in relation to clinical practicehttp://www.pagepress.org/journals/index.php/hi/article/view/4055CT angiography, stress testing, cardiac CT, coronary artery disease
spellingShingle Armin Arbab-Zadeh
Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm
Heart International
CT angiography, stress testing, cardiac CT, coronary artery disease
title Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm
title_full Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm
title_fullStr Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm
title_full_unstemmed Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm
title_short Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm
title_sort stress testing and non invasive coronary angiography in patients with suspected coronary artery disease time for a new paradigm
topic CT angiography, stress testing, cardiac CT, coronary artery disease
url http://www.pagepress.org/journals/index.php/hi/article/view/4055
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