title: Coronary artery computed tomography as the first-choice imaging diagnostics in patients with high pre-test probability of coronary artery disease (CAT-CAD).
abstract: BACKGROUND
  The primary diagnostic examination performed in patients with a high pre-test probability of coronary artery disease (CAD) is invasive coronary angiography. Currently, approximately 50% of all invasive coronary angiographies do not end with percutaneous coronary intervention (PCI) because of the absence of significant coronary artery lesions. It is desirable to eliminate such situations. There is an alternative, non-invasive method useful for exclusion of significant CAD, which is coronary computed tomography angiography (CCTA).
  
  
  OBJECTIVE
  We hypothesize that use of CCTA as the first choice method in the diagnosis of patients with high pre-test probability of CAD may reduce the number of invasive coronary angiographies not followed by interventional treatment. Coronary computed tomography angiography also seems not to be connected with additional risks and costs of the diagnosis. Confirmation of these assumptions may impact cardiology guidelines.
  
  
  METHODS
  One hundred and twenty patients with indications for invasive coronary angiography determined by current ESC guidelines regarding stable CAD are randomized 1 : 1 to classic invasive coronary angiography group and the CCTA group.
  
  
  RESULTS
  All patients included in the study are monitored for the occurrence of possible end points during the diagnostic and therapeutic cycle (from the first imaging examination to either complete revascularization or disqualification from the invasive treatment), or during the follow-up period.
  
  
  CONCLUSIONS
  Based on the literature, it appears that the use of modern CT systems in patients with high pre-test probability of CAD, as well as appropriate clinical interpretation of the imaging study by invasive cardiologists, enables precise planning of invasive therapeutic procedures. Our randomized study will provide data to verify these assumptions.
authors.affiliation: Department of Coronary and Structural Heart Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Piotr N
authors.initials: PN
authors.lastname: Rudziński
authors.affiliation: Department of Coronary and Structural Heart Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kruk
authors.affiliation: Department of Coronary and Structural Heart Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Demkow
authors.affiliation: Department of Coronary and Structural Heart Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Dzielińska
authors.affiliation: Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Pręgowski
authors.affiliation: Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
authors.affiliation: Department of Coronary and Structural Heart Disease, Institute of Cardiology, Warsaw, Poland ; Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Rużyłło
authors.affiliation: Department of Coronary and Structural Heart Disease, Institute of Cardiology, Warsaw, Poland.
authors.forename: Cezary
authors.initials: C
authors.lastname: Kępka
keywords: coronary angiography; coronary artery disease; coronary tomographic angiography; multi-detector computed tomography