CT coronary angiography-guided cardiovascular risk screening in asymptomatic patients: is it time?

J. Graby, A. Khavandi, D. Thompson, P. Downie, C. Antoniades, J. C.L. Rodrigues

Research output: Contribution to journalReview articlepeer-review

4 Citations (SciVal)

Abstract

Cardiovascular disease (CVD) is the leading cause of death in the UK, whilst millions live with various forms of the disease. Coronary artery disease constitutes a significant portion of this morbidity and mortality, and is the leading cause of premature death. Increasing focus is thus being placed on the optimisation of CVD prevention, where risk screening plays a key role. Indeed, the decline in age-adjusted cardiovascular mortality achieved up to now has been largely attributed to primary preventative therapies (e.g., statins) introduced earlier in the disease process. National initiatives exist to improve cardiovascular health at a population level, but in its current form, CVD screening at the individual level is predominantly undertaken using multivariate risk scores based on population-based data. These have multiple innate flaws, highlighted in this review. Non-invasive imaging plays a key role in the screening of other disease processes, helping to personalise the screening process. Although the coronary artery calcium score as a screening tool has a role in national and international guidance, whether a shift to screening with computed tomography coronary angiography (CTCA) is now appropriate is open for discussion. Image acquisition techniques continue to improve with reducing radiation exposure and an ever-expanding evidence-base for additional prognostic data offered by CTCA. This enables the potential identification of sub-clinical atherosclerosis, including with novel artificial intelligence techniques. This review aims to report current guidelines regarding cardiac CT imaging in the asymptomatic primary prevention setting, advances in various CT technologies and future opportunities for progress in this field.

Original languageEnglish
Pages (from-to)801-811
Number of pages11
JournalClinical Radiology
Volume76
Issue number11
Early online date14 Aug 2021
DOIs
Publication statusPublished - 30 Nov 2021

Bibliographical note

Funding Information:
Dr Jonathan Rodrigues reports a relationship with NHSX that includes: consulting or advisory. Dr Jonathan Rodrigues reports a relationship with Sanofi that includes: speaking and lecture fees. Dr Jonathan Rodrigues reports being co-founder and partner of Heart and Lung Imaging LTD. Dr Paul Downie reports a relationship with Sanofi that includes: speaking and lecture fees. Professor Charis Antoniades reports a relationship with British Heart Foundation that includes: funding grants. Professor Charis Antoniades reports a relationship with Innovate UK that includes: funding grants and non-financial support. Professor Charis Antoniades reports a relationship with The European Commission that includes: funding grants. Professor Charis Antoniades reports a relationship with National Institute for Health Research Oxford Biomedical Research Centre (Oxford, United Kingdom) that includes: non-financial support. Professor Charis Antoniades has patent #PCT/GB2015/052359 pending to Caristo Diagnostics. Professor Charis Antoniades has patent #PCT/GB2017/053262 pending to Caristo Diagnostics. Professor Charis Antoniades has patent #GB2018/1818049.7 pending to Caristo Diagnostics. Professor Charis Antoniades has patent #GR2018/0100490 pending to Caristo Diagnostics. Professor Charis Antoniades has patent #GR20180100510 pending to Caristo Diagnostics. Professor. Antoniades reports being Founder and Chief Scientific Officer for Caristo Diagnostics. Professor Charis Antoniades reports being Director of Acute Vascular Imaging Centre and its Core Lab.

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint

Dive into the research topics of 'CT coronary angiography-guided cardiovascular risk screening in asymptomatic patients: is it time?'. Together they form a unique fingerprint.

Cite this