Coronary artery disease develops when atherosclerotic plaque builds up in the coronary arteries, the blood vessels that supply the heart muscle.
Coronary CT angiography allows doctors to look directly at these arteries.
Using CT imaging and intravenous contrast, the examination can show whether coronary atherosclerosis is present, where it is located and whether it is causing narrowing of the coronary arteries.
Importantly, coronary CT angiography can identify more than severe narrowing.
It can also detect non-obstructive coronary atherosclerosis — plaque that is already present in the artery but does not significantly restrict blood flow.
Why does this matter?
Atherosclerosis develops gradually and may be present before it causes significant obstruction or symptoms. Identifying coronary plaque can therefore provide information that would not be available from symptoms or cardiovascular risk factors alone.
The presence and extent of coronary artery disease can also help doctors interpret a person’s cardiovascular risk and decide whether preventive management should be considered or intensified.
In the SCOT-HEART study, adding coronary CT angiography to the assessment of patients with stable chest pain improved the identification of coronary artery disease and influenced subsequent treatment. At 10-year follow-up, patients whose assessment included coronary CT angiography had fewer non-fatal myocardial infarctions or deaths from coronary heart disease.
