Computed Tomography as the First-Choice Diagnostics in High Pre-Test Probability of Coronary Artery Disease

Coronary Artery Computed Tomography as the First-Choice Imaging Diagnostics in Patients With High Pre-Test Probability of Coronary Artery Disease

To evaluate the safety and effectiveness of computed tomography angiography in the diagnostic and therapeutic cycle as the first-choice method of imaging in the diagnosis of patients with a high probability of stable coronary artery disease according to European Society of Cardiology recommendations.

A prospective, randomized open-label, single center trial to evaluate superiority of angio-CT to a classic coronary angiography (concerning effectiveness and safety) in the diagnosis of stable coronary artery disease in patients with indications for invasive coronary angiography.

Inclusion Criteria:

1. Age >18 years

2. Patients providing written informed consent

3. Indications for elective invasive coronary angiography defined by European Society of Cardiology as:

   • Left ventricle ejection fraction <50% and typical angina symptoms,
   • Probability of coronary artery disease due to criteria of age, sex and symptoms >85%, or
   • Probability of coronary artery disease due to criteria of age, sex and symptoms 50-85% with positive or moderate cardiac stress test.

Exclusion Criteria:

1. No Consent to the study
2. Acute coronary syndrome
3. Recurrence of typical angina symptoms 1 year after the last percutaneous coronary revascularization,
4. Contraindications to invasive coronary angiography
5. GFR <60 ml/min/1.73m2
6. Significant arrhythmia
7. BMI >35 kg/m2