Comparison of the Diagnostic Power of Computed Tomography Coronary Angiography and Exercise Electrocardiography as a First Screening Test in Real-World Practice: Is It Ready for Clinical Use?

흉통의 일차 선별 검사로서 관상동맥 컴퓨터 단층 촬영술과 운동부하 심전도 검사

Exercise electrocardiography (XECG) is a widely used noninvasive test for screening coronary artery disease that is endorsed by current clinical guidelines. However, its clinical use is limited by its modest diagnostic accuracy. Coronary computed tomographic angiography (CCTA) has emerged as a new tool for screening coronary artery disease. In this issue, CCTA performed better diagnostically than XECG when invasive coronary angiography was used as the diagnostic standard. In addition, invasive coronary angiography was chosen based on CCTA, rather than XECG. Although this study suffers from the lack of an appropriate diagnostic standard, the clinical course identified implies that clinical practice might be influenced by sophisticated anatomical imaging to a considerably greater extent than by a simple physiological assessment.