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The following is a summary of “Coronary computed tomography angiography in primary care patients with chest pain or dyspnea – a cross-sectional study,” published in the May 2025 issue of BMC Primary Care by Stertman et al. 

Researchers conducted a retrospective study to examine Coronary Computed Tomography Angiography (CCTA) findings in relation to the pre-test probability (PTP) of individuals referred directly from primary health care centers for cardiology and pain evaluation.  

They included consecutive CCTA referrals from primary care in a Swedish county between 1st June 2021 and 30th November 2022. A total of 483 individuals aged ≥30 years without known coronary artery disease (CAD) were reviewed, and CCTA findings were classified as no CAD, atheromatosis, or suspected significant stenosis. The PTP data were available for 381 individuals.  

The results showed that the mean age among those with eligible PTP data was 60 years, and 70% were women. The median PTP was 11%, with suspected significant stenosis identified in 18% of CCTA cases. Among individuals with PTP ≤ 15%, 88% had no significant stenosis. In a sensitivity analysis of 25 individuals with PTP < 5%, no significant stenosis was found, aligning with age- and gender-specific expectations.  

Investigators concluded that CCTA effectively ruled out coronary stenosis in most individuals with PTP 5–15%, while PTP estimates >15% underestimated the presence of significant stenosis and estimates <5% showed low validity. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02877-z