CCTA beats exercise stress in finding coronary stenosis

Coronary CT angiography (CCTA) can detect significant coronary artery stenosis in 90% of those who have it, compared with 60% of those who undergo treadmill stress testing, according to a new multinational study in Circulation.

In their study, researchers from Johns Hopkins University and 16 other institutions in eight countries examined 391 patients with suspected coronary artery disease. They compared the use of CCTA with nuclear-based exercise stress testing and invasive angiography. CCTA ruled out disease in 91% of patients, compared with 69% for stress testing, the researchers found (Circulation, October 14, 2015).

"No test is 100% accurate 100% of the time, but our findings indicate CT angiograms get pretty close to that coveted threshold," said lead investigator Dr. Armin Zadeh, PhD, from Johns Hopkins, in a statement. "We hope our findings will settle any residual uncertainty about the effectiveness of these two common noninvasive heart tests."

What makes the study particularly powerful is that all patients underwent all three tests. In addition, the results show conclusively that CCTA is far better than stress testing at spotting clogged arteries, even though most patients still undergo stress testing, according to the authors.