Contemporary, non-invasive imaging diagnosis of chronic coronary artery disease
: van der Bijl, Pieter; Gulati, Martha; Saraste, Antti; Marwick, Thomas; Kwong, Raymond; Blankstein, Ron; Nieman, Koen; Sengupta, Partho P.; van Rosendael, Alexander; Knuuti, Juhani; Bangalore, Sripal; Bax, Jeroen J.
Publisher: Elsevier
: 2025
Lancet
: 406
: 10519
: 2577
: 2587
: 0140-6736
: 1474-547X
DOI: https://doi.org/10.1016/S0140-6736(25)01586-7
: https://doi.org/10.1016/s0140-6736(25)01586-7
Coronary artery disease is one of the leading causes of morbidity and mortality worldwide. Although it can present with an acute coronary syndrome, it is often characterised by long periods of stability, known as chronic coronary artery disease. This Review presents a comprehensive overview of the diagnosis of the disease, with a focus on cardiac imaging. We discuss various cardiac imaging modalities, including CT coronary angiography, stress echocardiogram, stress single-photon emission CT, PET, and stress cardiac magnetic resonance. We also compare the roles of anatomical (eg, CT coronary angiography) versus functional (eg, stress echocardiogram) tests and examine the potential utility of artificial intelligence in more detail.
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The Department of Cardiology of Leiden University Medical Centre (Leiden, The Netherlands) received research grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, and Medtronic. The Baker Heart and Diabetes Institute (Melbourne, VIC, Australia) received research grants from the National Health and Medical Research Council (Australia), the Medical Research Future Fund (Australia), and AstraZeneca. KN received research grants from the National Institutes of Health, the National Heart, Lung and Blood Institute, Siemens, and Novartis, and consulting fees from Cleerly, Artrya, and Novartis. PPS received funding support from the National Science Foundation (NST) Award (2125872) and the NST Research Traineeship Harnessing the Data Revolution programme: Bridges in Digital Health; has served on the advisory board of RCE Technologies and HeartSciences and holds stock options; and has received grants or contracts from RCE Technologies, HeartSciences, Butterfly, and MindMics and has patents with Mayo Clinic (US8328724B2), HeartSciences (US11445918B2), and Rutgers Health (62/864 771, US202163152686P, WO2022182603A1, US202163211829P, WO2022266288A1, and US202163212228P). JK received consulting fees from GE Healthcare and Synektik. SB received consulting fees from Abbott Vascular, Boston Scientific, Biotronik, Pfizer, Inari, Truvic, and Recor. All other authors declare no competing interests.
