CT is the new standard for the diagnosis of coronary artery disease in daily practice

Abstract

Computed tomography coronary angiography (CTCA) is increasingly integrated into current guidelines and clinical practice. In the Netherlands, the uptake of CTCA in clinical practise is low [1]. Currently, CTCA practice in the Netherlands is characterized by heterogeneous standard operation procedures and quality standards precluding optimal usage in the clinical field. National trend analyses in the Netherlands and the United Kingdom indicate a substantial increase in CTCA usage in the near future up to at least 300% [1]. We need to change our current practise for diagnosing coronary artery disease and change does not come easy. Therefore this special issue of the Netherlands Heart Journal focuses on the current evidence, standards and practices of CTCA, shedding light on ongoing studies as well as future and upcoming developments across six chapters. These papers cover topics such as the early detection of coronary artery disease [2], the implementation of the CAD-RADS reporting system [3], and its application in trials such as the CLEAR-CAD trial [4]. The CLEAR-CAD trial is the largest clinical trial in the Netherlands, currently investigating a combined CT-first diagnostic and optimal medical treatment strategy for the clinical assessment of chest pain in the outpatient setting.Many chest pain patients in the Netherlands are still not undergoing the guideline-recommended CTCA. A significant proportion of patients in the J. P. S. Henriques ( )