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Role of cardiac CT
CT is an increasingly pivotal diagnostic tool for cardiovascular disease and preprocedural planning for structural intervention and device implantation. CT coronary angiography (CTCA) has gained prominence in UK clinical practice as it is now recommended in the National Institute for Health and Care Excellence guidelines as the first-line test for the investigation of anginal symptoms in those without known coronary artery disease (CAD).1 CTCA is an excellent rule-out test for CAD (figure 1) but has an increasingly robust positive predictive value, especially when combined with CT-fractional flow reserve,2 which is currently being funded as part of an NHS England Innovation programme. Recent evidence has demonstrated the addition of CTCA to standard of care in patients from rapid access chest pain clinics reduced non-fatal myocardial infarction rates by over 40%.3
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