News | CT Angiography (CTA) | September 17, 2019

Continuation of 2013 guidelines recommends coronary CT angiography as initial test to rule out or establish diagnosis of chronic coronary syndromes

New ESC Guideline Provides Class 1 Recommendation for Coronary CTA

September 17, 2019 — The European Society of Cardiology (ESC) published new guidelines on the diagnosis and management of chronic coronary syndromes (CCS), which classifies computed tomography angiography (CTA) as a Class 1 recommendation for diagnosing CAD in symptomatic patients. The document, which is a continuation of the 2013 stable coronary artery disease (CAD) guidelines, updates the term to CCS to emphasize the dynamic nature of the disease. It was released at the 2019 ESC Congress, Aug. 31-Sept. 4 in Paris, France, and published simultaneously in the European Heart Journal.1 

Per the guideline, unless obstructive CAD can be excluded based on clinical evaluation alone, either non-invasive functional imaging or anatomical imaging using coronary CTA should be used as the initial test to rule out or establish the diagnosis of CCS.

The new guideline suggests that "Coronary CTA is the preferred test in patients with a lower range of clinical likelihood of CAD, no previous diagnosis of CAD and characteristics associated with a high likelihood of good image quality."

“Depending on patient characteristics, local expertise and availability, as well as patient-specific considerations, physicians should decide between coronary CTA and ischemia testing,” said ESC President-elect Stephan Achenbach, M.D., FSCCT. “This is a recognition of the numerous trials that have been performed to establish the usefulness and reliability of CT angiography as a first-line examination."

“The guideline recommendations are based on data that shows that the use of coronary CTA leads to accurate identification of coronary artery disease, which if treated appropriately, can lead to improved patient outcomes.” added Ron Blankstein, M.D., FSCCT, president of SCCT. “The guidelines recognize that there are multiple factors that should be used in test selection, but that for many, a coronary CTA-first approach is beneficial.”

The guidelines also place stronger emphasis on lifestyle behaviors, and for the first time, address the negative impact of pollution and noise on CCS patients. Additionally, an annual flu vaccination, particularly for elderly patients, is recommended, as is behavioral counseling.

For more information:



1. Knuuti J., Wijns W., Saraste A., et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). European Heart Journal, published online Aug. 31, 2019.

Related Content

News | Radiology Business

May 11, 2022 — Enlitic, a leading AI healthcare company, has welcomed Dave Wilson as the vice president of marketing and ...

Time May 11, 2022
News | Magnetic Resonance Imaging (MRI)

May 3, 2022 — More than 60 million magnetic resonance imaging (MRI) scans are performed worldwide each year, but imaging ...

Time May 04, 2022
News | Cardiac Imaging

May 2, 2022 — According to ARRS’ American Journal of Roentgenology (AJR), routine visual ordinal coronary artery calcium ...

Time May 02, 2022
News | Cardiac Imaging

April 28, 2022 — Aspirin therapy, as opposed to statin use, for non-obstructive coronary artery disease does not reduce ...

Time April 28, 2022
News | Lung Imaging

April 11, 2022 — Radiation to the heart during treatment for locally advanced lung cancer is associated with an ...

Time April 11, 2022
Feature | Radiation Dose Management | By Melinda Taschetta-Millane

Dose tracking software allows hospitals and imaging centers to track levels of radiation used by exam type protocol. It ...

Time March 22, 2022
News | Enterprise Imaging

March 16, 2022 — ScImage, Inc., a leading provider of Cloud-centric enterprise imaging and reporting solutions ...

Time March 16, 2022
News | SPECT Imaging

February 18, 2022 — GE Healthcare has announced that it has received approval from the European Medicines Agency (EMA) ...

Time February 18, 2022
News | Coronavirus (COVID-19)

February 17, 2022 — While cardiac imaging shows that COVID-19 vaccine–associated myocarditis has a similar pattern as ...

Time February 17, 2022
News | Point-of-Care Ultrasound (POCUS)

February 15, 2022 — Fujifilm Sonosite, Inc. – a world leader in point-of-care ultrasound (POCUS) solutions – has added ...

Time February 15, 2022
Subscribe Now