The Utility of Coronary CT Angiography in Evaluating Symptomatic Patients with Positive MPI Referred for Coronary Angiography: A Single-center Experience

Abstract

Background: Patients with suspected or known coronary artery disease (CAD) can be challenging to evaluate. Our study aims to assess the efficacy and utility of coronary computed tomographic angiography (CCTA) as a diagnostic method in patients with abnormal myocardial perfusion imaging (MPI) who were initially referred for Invasive Coronary Angiography (ICA). Methods: This is a single-center retrospective descriptive study. We evaluated 210 patients who underwent CCTA instead of ICA. Data of these patients were documented and analyzed accordingly. Results: Of the 210 patients who underwent CCTA, the procedure was found to be diagnostic in 172 (81.9%) patients. Of these 172 patients, 152 (88.4%) had normal coronaries or minor CAD, and 20 (11.6%) had significant disease requiring subsequent ICA. In 38 (18.1%) patients out of the total cohort, the CCTA was not diagnostic or could not be performed due to technical difficulties, requiring either ICA or another ischemia evaluation diagnostic modality. Conclusion: CCTA is a viable and reliable diagnostic tool for evaluating patients with suspected CAD referred for ICA following an abnormal MPI test. It is recommended as an initial test to rule out significant coronary stenosis and as it can avoid unnecessary ICA.