Computed tomographic coronary angiography - is it ready as a screening tool for coronary artery disease?

Currently, there are no formal screening programmes for coronary artery disease (CAD). Computed tomographic coronary angiography (CTCA) has been suggested as a non-invasive and reliable method of atherosclerotic plaque assessment, with the potential for use in screening programmes. In this article, we briefly present the current understanding of atherosclerotic plaque formation, explain key technological aspects of CTCA and critique this method in the light of World Health Organisation (WHO) criteria for devising a screening programme. Current evolving and future insights are also considered. Overall, in our view, there is currently insufficient evidence to support the formal use of CTCA in a screening programme for CAD, although this viewpoint will undoubtedly evolve.