Computed tomography (CT) angiography may be the most effective strategy for assessing patients with stable angina, according to a press release from the American College of Cardiology (ACC). Previous research has indicated that a low proportion of patients with stable angina who undergo invasive coronary angiography are diagnosed with obstructive coronary artery disease; however, CT angiography may benefit patients when used as an initial evaluation strategy. In a new study presented at the ACC Cardiovascular Summit 2024, researchers analyzed 786 patients without a previous coronary artery disease diagnosis who underwent invasive coronary angiography for suspected angina between October 2022 and June 2023. They noted that prior to the invasive examination, 44% of patients received no noninvasive testing, 36% underwent CT angiography, 15% had stress myocardial perfusion imaging, 3% underwent stress echocardiogram, and 2% had magnetic resonance imaging (MRI). Compared with those who had other imaging modalities performed or had no testing, the patients who underwent CT angiography were more likely to receive subsequent coronary revascularization to restore adequate blood flow (62% vs 34%). Although CT angiography most frequently led to revascularization in this patient population, current guidelines do not specify a preference for the imaging strategy because many health systems may not have access to high-quality CT scanners or qualified physicians who can interpret the results. Further, some patients may not be indicated for CT angiography because some factors can reduce the accuracy of the scans. The researchers concluded that despite these challenges, CT angiography could be cost-effective; may provide detailed data on the absence, presence, and extent of coronary atherosclerosis, high-risk plaque, and vessel blockages; and may improve patient management and outcomes.