“It likely will take years before these changes will be implemented into guidelines,” Dr. Zadeh explained. “This is the nature of our system. In the meantime, each physician has to decide for herself/himself what’s best for the patient.”

Each test has its limitations, he said, which need to be weighed against its benefits. He does not endorse an indiscriminate prescribing pattern of cardiac CTs, he added.


“Our study used equipment that may not be available in the community, but only at larger referral centers. In low-risk patents, a simple exercise treadmill test without imaging is probably the best test after all because the probability of disease is so low,” he said. “Only patients of intermediate risk features are most likely to benefit from cardio CT scanning if they have symptoms suggestive of coronary artery disease.”

Johns Hopkins’ next studies are aiming at investigating the utility of CT to replace cardiac catheterization, “which would be a great achievement,” Zadeh said.

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