For individuals with intermediate probability of stable coronary artery disease, CTCA is a sensitive method, i.e. it misses few clinically significant stenoses. However, it is less specific, i.e. occasionally it indicates a constriction when there is no clinically significant stenosis. In the studies of individuals with intermediate probability of coronary artery disease, sensitivity is 94 to 100 percent, and specificity is 63 to 94 percent.

Optimising the diagnostic test accuracy of the method and reducing the radiation dose would require investing in modern equipment and staff training.

For the patient group as a whole, it is estimated that a strategy starting with CTCA would currently lead to a higher radiation dose than using ICA alone, assuming that the prevalence of clinically significant stenoses is 55 percent. The lower the prevalence of clinically significant stenoses, the lower the total radiation dose at the group level with the CTCA strategy. The reason is that fewer patients would require further examination after CTCA.

New computed tomography equipment delivers a lower effective radiation dose compared to ICA. Currently, a CTCA examination with state-of-the-art equipment delivers an effective radiation dose similar in magnitude to the natural background radiation per year.

In Sweden, a CTCA examination costs approximately half as much as an ICA examination. The total cost of the CTCA strategy depends on the number of patients that must be examined with both CTCA and ICA. Assuming a 55 percent prevalence of clinically significant stenoses, the CTCA strategy is estimated to be somewhat more expensive than using ICA alone. The lower the probability of clinically significant stenoses, the lower the total cost of the CTCA strategy.

Controlled trials are needed to assess CTCA as a prognostic and treatment management tool for coronary artery disease.