The treatment of coronary artery disease (CAD), which is defined by stable anatomical atherosclerotic and functional alterations of epicardial vessels or microcirculation, focuses on managing intermittent angina symptoms and preventing major adverse cardiovascular events with optimal medical therapy. When patients with known CAD present with angina and no acute coronary syndrome, they have historically been evaluated with a variety of noninvasive stress tests that utilize electrocardiography, radionuclide scintigraphy, echocardiography, or magnetic resonance imaging for determining the presence and extent of inducible myocardial ischemia. Patient event-free survival, however, is largely driven by the coronary atherosclerotic disease burden, which is not directly assessed by functional testing. Direct evaluation of coronary atherosclerotic disease by coronary computed tomography angiography (coronary CTA) has emerged as the first line noninvasive imaging modality as it improves diagnostic accuracy and positively influences clinical management. Compared to functional assessment of CAD, coronary CTA-guided management results in improved patient outcomes by facilitating prevention of myocardial infarction. Other strengths of coronary CTA include detailed atherosclerotic plaque characterization and the ability to assess functional significance of specific lesions, which may further improve risk assessment and prognosis and lead to more appropriate referrals for additional testing, such as invasive coronary angiography.

冠状动脉疾病(CAD) 的治疗定义为稳定的解剖动脉粥样硬化和心外膜血管或微循环的功能改变，重点是控制间歇性心绞痛症状和通过最佳药物治疗预防主要不良心血管事件。当已知 CAD 患者出现心绞痛且无急性冠状动脉综合征时，他们历来接受过各种无创压力测试评估，这些测试利用心电图、放射性核素闪烁显像、超声心动图或磁共振成像来确定可诱导心肌缺血的存在和程度. 然而，患者的无事件生存率很大程度上是由冠状动脉粥样硬化疾病负担驱动的，这不是通过功能测试直接评估的。通过冠状动脉计算机断层扫描血管造影（冠状动脉 CTA）直接评估冠状动脉粥样硬化疾病已成为一线无创成像方式，因为它提高了诊断准确性并对临床管理产生积极影响。与 CAD 的功能评估相比，冠状动脉 CTA 指导的管理通过促进预防心肌梗塞来改善患者的预后。冠状动脉 CTA 的其他优势包括详细的动脉粥样硬化斑块特征和评估特定病变功能意义的能力，这可能会进一步改善风险评估和预后，并导致更合适的转诊进行额外的测试，例如侵入性冠状动脉造影。