The Added Value of Cardiac Computed Tomography in Early Detection of Coronary Artery Disease: A single-centre Retrospective Analysis of Asymptomatic Individuals with low-to-medium pre-test probability

Irene S. Mastorakou, Markos Marios L. Kaklamanis, Dionissios Kyriakopoulos, Emmanouil Michail Arvanitis, Sofia Georgantzi, Panagiotis Kalomitsinis


Purpose: To evaluate the contribution of Cardiac Computed Tomography (CCT) in the early detection of coronary atheromatosis in asymptomatic individuals with or without risk factors for Coronary Artery Disease (CAD).

Materials and Methods: This is a retrospective, single centre study of 373 asymptomatic individuals with low-to-medium pre-test probability for CAD who performed CCT to exclude CAD, between September 2020 and November 2021. All individuals had a Coronary Artery Calcium (CAC) test, followed by a Coronary Computed Tomography Angiography (CCTA), unless CAC scoring (CACS) was above 1000 with the Agatston scoring system. CAC was estimated with the Agatston scoring system and the CAD-RADs system was used to assess the presence and extent of CAD.

Results: 58.4% of the participants were detected with coronary atheromatosis (CACS>0) when the CAC test was considered, with 16% of those having CAC>400 with a high likelihood of at least one coronary stenosis. When assessed with CCTA, 68% of the participants were detected with coronary atheromatosis and any degree of CAD, 11.6% with significant stenosis and 7.8% with severe stenosis. Nine (9) participants without risk factors were detected with minimal atheromatosis and one with moderate atheromatosis. Fifteen participants were under 40y with three (3) of them detected with minimal and two (2) with mild atheromatosis.

Conclusions: CCTA has the potential of becoming the established method for the early diagnosis of coronary atheromatosis and CAD. CCTA is superior to CAC for the early diagnosis of coronary atheromatosis and CAD. Individuals who may benefit from CCTA are diabetics, young males with multiple risk factors for CAD and middle-aged males with no risk factors for CAD.


asymptomatic patients;Coronary Artery Disease; Cardiac Computed Tomography; Coronary Computed Tomography Angiography; Coronary Artery Calcium

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