Prognostication of cardiac CT angiography

The rapidly emerging technique of cardiac computed tomography angiography (CTA) has enabled the anatomical assessment of coronary artery disease. CTA has very good diagnostic accuracy with the ability to detect nonobstructive from obstructive coronary artery disease and provides information on the presence of coronary artery calcification as well as on left ventricular function. Over the last few years, many prognostic studies have reviewed the outcome benefit of different scoring indices in predicting hard cardiac events. The following article will review the most recent literature available on the use of CTA in measuring luminal stenoses, identifying high-risk obstructive CAD, calcium plaque score, and LV function all in different models with their impact on the estimation of clinical risk. More recent data from a large multicenter registry supports the incremental benefit of CAD severity and LVEF as independent predictors of prognosis. Future directions and emerging applications such as the utility of CTA combined with perfusion analysis may lead to a new anatomical-functional diagnostic test that may provide optimal noninvasive assessment of coronary artery anatomy and be superior to invasive coronary angiography.