CT Scan Vs Stress Test: Which Is Better for Identifying CAD?

Noninvasive CT scans are significantly more effective at identifying coronary artery disease (CAD) in patients with chest pain than commonly performed exercise stress tests, according to a recent head-to-head comparison study.

In the past, exercise stress tests have frequently been used for evaluating CAD, but CT scans have also been shown to be a valid alternative.
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To compare these 2 methods, researchers conducted a study of 391 symptomatic patients enrolled after referral for cardiac catheterization. All patients underwent noninvasive CT scans followed by catheter-based coronary angiographies. Within 2 months, all patients also underwent exercise stress tests.

Overall, CT scan accurately identified clogged arteries in 91% of patients, compared to 69% identified by stress tests. In a subgroup of 111 high-risk patients, CT was accurate in 96% of patients, compared with 80% for stress tests.

“No tests is 100 percent accurate 100 percent of the time, but our findings indicate CT angiograms get pretty close to that coveted threshold,” researchers concluded.

“We hope our findings will settle any residual uncertainty about the effectiveness of these 2 common noninvasive heart tests.”

—Michael Potts

Reference:

Johns Hopkins Medicine. Heart CT scans outperform stress tests in spotting clogged arteries [press release]. October 26, 2015. http://www.hopkinsmedicine.org/news/media/releases/heart_ct_scans_outperform_stress_tests_in_spotting_clogged_arteries.