Value of coronary CTA in patients with known or suspected CAD and non-diagnostic initial myocardial perfusion testing: current evidence and clinical considerations.

摘要

Over the last several decades, nuclear myocardial perfusion imaging (MPI) utilizing gated SPECT technology and multiple stressors has become a major clinical tool in daily cardiology practice, allowing selection of patients at high risk of myocardial ischemia and future cardiac events, and effectively providing the option of more aggressive therapy to these patients.1 Many centers have implemented MPI as a "standard-of-care" methodology for their emergency departments and "chest pain units." MPI, in these circumstances, has proven to be a safe and cost-effective gatekeeper both for admission/discharge decision making2 and for referrals for invasive coronary angiography.3 The MPI-guided strategy has also proven effective in managing outpatient populations with stable chronic chest pain syndromes.