To compare the efficacy of 16-row multi-detector CT (MDCT) with standard myocardial perfusion imaging in detecting coronary artery disease (CAD) in patients without a previously established diagnosis of CAD.

Nuclear stress testing is currently the established non-invasive modality in detecting flow-obstructing coronary artery disease (CAD).

Recently, multi-detector CT (MDCT) has emerged as a new modality that offers a non-invasive means to directly visualize coronary anatomy and any CAD. Studies have shown that MDCT has excellent sensitivity and a high negative predictive value in detecting significant CAD.

The purpose of this study is to compare MDCT with nuclear stress testing for detecting CAD in previously undiagnosed patients.

Inclusion Criteria:

• Referred for a clinical indicated stress SPECT MPI
• Adequate IV access in both arms

Exclusion Criteria:

• History of coronary angioplasty or stent placement
• History of coronary bypass surgery
• Angiographic history of flow-limiting CAD
• Documented history of elevated cardiac markers
• Documented history of injury or infarct on ECG
• Absence of sinus rhythm
• Current history of renal insufficiency
• Known allergy to contrast dye
• Pregnant

All patients without prior CAD referred for nuclear stress testing