Detection of relevant extracardiac findings on coronary computed tomography angiography vs. invasive coronary angiography.
While both coronary computed tomography angiography (CTA) and invasive coronary angiography (ICA) are well-established methods for the assessment of cardiac and coronary anatomy, they visualize also surrounding structures, such as lungs, mediastinum, and upper abdomen, leading to detection of extracardiac findings (ECFs). We performed a subanalysis of clinically relevant ECFs on CTA versus ICA in patients with atypical angina and suspected coronary artery disease (CAD) based on data from our randomized controlled CAD-Man trial. Our study showed that CTA detects ten times more clinically relevant ECFs than ICA. Some of those ECFs detected by CTA (13%) were identified as explaining patients’ chest pain and may thus affect management and therapy and consequently improve quality of life. Detection of ECFs explaining chest pain on CTA might also preclude the need for performing ICA, which is invasive and associated with more procedural complications than CTA.