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The ESC Textbook of Cardiovascular Imaging pp 267–286Cite as

Cardiac CT and Detection of Coronary Artery Disease

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Abstract

Cardiac CT allows non-invasive imaging of the coronary arteries. Under certain circumstances, it can, therefore, play an important role for diagnosing coronary artery disease. Particularly in patients with a relatively low pre-test likelihood of the disease, coronary CT angiography has been shown to allow for the detection of coronary stenoses with high sensitivity and is considered a useful technique to rule out coronary artery disease in selected clinical settings. Coronary artery imaging in patients with advanced disease or after coronary revascularization is more difficult and currently not considered a clinical indication for CT. In addition to detecting luminal stenosis, CT has the potential to visualize and characterize non-stenotic coronary atherosclerotic plaque. Based on a large amount of prognostic data, coronary calcium can be used for refined risk stratification concerning future cardiovascular events. Imaging of non-calcified plaque is currently considered experimental, and should not be used for clinical decision-making. Future improvements in image quality are expected to expand the clinical role of cardiac CT in the assessment of coronary artery disease.

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Authors and Affiliations

  1. University of Erlangen, Ulemenweg 18, Erlangen, 91054, Germany

    Stephan Achenbach MD

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  1. Stephan Achenbach MD
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  2. Pim J. de Feyter
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Correspondence to Stephan Achenbach MD .

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Editors and Affiliations

  1. Hospital Clinico San Carlos, Instituto Cardiovascular, C/Professor Martin Lagos, s/n, 28040, Madrid, Spain

    José Luis Zamorano

  2. Medical Center Dept. Cardiology, Leiden University, Albinusdreef 2, 2333, Leiden, ZA, Netherlands

    Jeroen J. Bax

  3. Dept. Cardiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Frank E. Rademakers

  4. Turku PET Centre, Turku University Hospital, FI-20521, Turku, Finland

    Juhani Knuuti

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Achenbach, S., de Feyter, P.J. (2010). Cardiac CT and Detection of Coronary Artery Disease. In: Zamorano, J.L., Bax, J.J., Rademakers, F.E., Knuuti, J. (eds) The ESC Textbook of Cardiovascular Imaging. Springer, London. https://doi.org/10.1007/978-1-84882-421-8_13

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