Diagnostic Accuracy of Computed Tomography (CT) Coronary Angiography Compared to Invasive Coronary Angiography for Detecting Coronary Artery Disease: A Systematic Review.

Coronary artery disease (CAD) is a significant cause of morbidity and mortality worldwide, and the prevalence is continually rising. Invasive coronary angiography (ICA) has been considered the gold standard in CAD diagnosis as it offers precise information about the presence and severity of coronary artery blockages. However, computed tomography coronary angiography (CTCA) has emerged as a preferred noninvasive imaging technique from the viewpoint of patient risk because it provides high-resolution coronary images. This systematic review aims to compare the diagnostic accuracy of CTCA with ICA to diagnose CAD among patients. This systematic literature review involved a database search of PubMed, Medline, and Cochrane Library for articles from 2014 to 2024. After screening 650 records, removing duplicates, and assessing 63 reports for eligibility, five studies were included in the final analysis. Diagnostic accuracy parameters like sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. The study found that CTCA demonstrated high to very high sensitivity and specificity in detecting CAD. It minimizes the number of such procedures and related consequences; other trials showed a significant decrease in myocardial infarctions over an extended period. CTCA appears reliable as an alternative to ICA, proving equally effective in low- to intermediate-risk patients but less effective in high-risk cases, where ICA remains necessary. CTCA provides an innovative, less invasive diagnostic solution for low- to moderate-risk patients, consistent with patient-directed care. However, due to the emphasis on its relative strengths, ICA remains relevant even today for high-risk individuals, especially those requiring the most urgent intervention. More recent developments and large-scale investigations are essential to optimize the use of CTCA in clinical practice and clarify its role in CAD treatment.