Prognostic value of cardiac CT

Sara Seitun, Alberto Clemente, Erica Maffei, Patrizia Toia, Ludovico La Grutta, Filippo Cademartiri

Research output: Contribution to journalArticlepeer-review

Abstract

In the past decades, coronary computed tomography angiography (CCTA) has become a powerful tool in the management of coronary artery disease. The diagnostic and prognostic value of CCTA has been extensively demonstrated in both large observational studies and clinical trials among stable chest pain patients. The quantification of coronary artery calcium score (CACS) is a well-established predictor of cardiovascular morbidity and mortality in asymptomatic subjects. Besides CACS, the main strength of CCTA is the accurate assessment of the individual total atherosclerotic plaque burden, which holds important prognostic information. In addition, CCTA, by providing detailed information on coronary plaque morphology and composition with identification of specific high-risk plaque features, may further improve the risk stratification beyond the assessment of coronary stenosis. The development of new CCTA applications, such as stress myocardial CT perfusion and computational fluids dynamic applied to standard CCTA to derive CT-based fractional flow reserve (FFR) values have shown promising results to guide revascularization, potentially improving clinical outcomes in stable chest pain patients. In this review, starting from the role of CACS and moving beyond coronary stenosis, we evaluate the existing evidence of the prognostic effectiveness of the CCTA strategy in real-world clinical practice.

Original languageEnglish
Pages (from-to)1135-1147
Number of pages13
JournalRadiologia Medica
Volume125
Issue number11
DOIs
Publication statusPublished - Nov 1 2020

Keywords

  • Atherosclerosis
  • CACS
  • CAD
  • Calcium score
  • Cardiac CT
  • Cardiovascular imaging
  • Chest pain
  • Coronary artery disease
  • Coronary computed tomography
  • FFR-CT
  • Prognosis
  • Risk assessment
  • Risk factors
  • Stratification

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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