Neue Kardio-CT-Guidelines – Implikationen für die Praxis?

Abstract

Cardiac computed tomography (CT) allows for non-invasive evaluation of the coronary arteries. Coronary calcium is a measure of coronary atherosclerosis. Determining coronary calcium by using CT is useful for further risk stratification if the Framingham risk score defines an intermediate cardiovascular risk ranging between (6 - )10 % and 20 % in 10 years. In this case, many subjects’ risk can be reclassified on the basis of the calcium score, and the intensity of risk factor treatment can be adapted accordingly. Non-invasive coronary CT angiography (CTA) is a highly sensitive tool for detecting significant coronary stenoses. As opposed to the luminogram obtained with invasive coronary angiography, CTA also defines plaque build-up in the coronary wall. This occasionally results in an overestimation of stenosis severity. However, the negative predictive value is high, providing for the ability to rule out significant stenoses with a high degree of certainty.

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