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Coronary CTA and Calcium Scoring

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Handbook of Outpatient Cardiology

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Abstract

Coronary CT angiography (cCTA) is an alternative imaging modality to functional stress testing in patients with reasonable clinical suspicion of nonacute ischemia or acute coronary syndromes (ACS) without definite objective evidence of ACS on EKG or myocardial necrosis by biomarkers. It allows a safe early discharge of patients presenting to the ED with chest pain. It is also useful when the stress test result is equivocal, when baseline ECG abnormalities are present, or when the patient is unable to walk. Cardiac CT can also assess the total coronary calcium burden and the calcium burden of each coronary artery. Coronary calcium has a weak correlation with the presence and severity of an angiographic stenosis, and thus it is most clinically reasonable to utilize in the decision to withhold, postpone, or initiate statin therapy if there is uncertainty about cardiovascular risk or if it is the patient preference to avoid statin therapy.

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Abbreviations

ACS:

Acute coronary syndromes

ASCVD:

Atherosclerotic cardiovascular disease

CABG:

Coronary artery bypass graft

CAC:

Coronary artery calcium

CAD:

Coronary artery disease

CAD-RADS:

Coronary Artery Disease-Reporting and Data System

CCS:

Coronary calcium score

cCTA:

Coronary computed tomography angiography

CT:

Computed tomography

ECG:

Electrocardiogram

FFRCT:

Fractional flow reserve derived from computed tomography

HU:

Hounsfield units

ICA:

Invasive coronary angiography

LM:

Left main

MACE:

Major adverse cardiac events

MDCT:

Multi-detector computed tomography

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Authors and Affiliations

  1. Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA

    Bruno B. Lima, Parth Patel & Patrick Gleason

Authors
  1. Bruno B. Lima
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  2. Parth Patel
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  3. Patrick Gleason
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Corresponding author

Correspondence to Patrick Gleason .

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Editors and Affiliations

  1. Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA

    Ankit A. Bhargava

  2. Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA

    Bryan J. Wells

  3. Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Pablo A. Quintero

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Lima, B.B., Patel, P., Gleason, P. (2022). Coronary CTA and Calcium Scoring. In: Bhargava, A.A., Wells, B.J., Quintero, P.A. (eds) Handbook of Outpatient Cardiology . Springer, Cham. https://doi.org/10.1007/978-3-030-88953-1_8

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  • DOI: https://doi.org/10.1007/978-3-030-88953-1_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-88952-4

  • Online ISBN: 978-3-030-88953-1

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