Clinical role of computed tomography-based angiography of the coronary arteries (coronary CT-angiography) for cardiology and cardiac surgery 2026: Consensus paper of the German Cardiac Society (DGK) and the German Society for Thoracic, Cardiac and Vascular Surgery (DGTHG) Stellenwert der Computertomographie-basierten Angiographie der Koronararterien (koronare CT-Angiographie) für die Kardiologie und Herzchirurgie 2026: Konsensuspapier der Deutschen Gesellschaft für Kardiologie (DGK) und der Deutschen Gesellschaft für Thorax‑, Herz- und Gefäßchirurgie (DGTHG)
Achenbach S, Smetak N, Assmann A, Dörge H, Thiele H, Gummert J, Hell MM, Rudolph TK, Doenst T, Falk V, Perings CA, Börgermann J (2026)
Publication Type: Journal article, Review article
Publication year: 2026
Journal
DOI: 10.1007/s12181-025-00785-1
Abstract
Coronary computed tomography angiography (coronary CTA) provides high diagnostic accuracy for the detection or exclusion of obstructive stenoses in patients with low to intermediate pretest probability; however, the diagnostic accuracy decisively depends on high imaging quality, which in turn requires modern CT systems, thorough patient preparation and optimized examination protocols. According to current guidelines, coronary CTA together with imaging based ischema tests is recommended as a first-line diagnostic modality for suspected chronic coronary syndrome within the low to intermediate pretest probability range (class I‑A indication). It is given priority over other procedures with a class I‑B recommendation; however, this is only true when an unimpaired imaging quality can be expected based on the patient characteristics. A completely inconspicuous result with exclusion of stenoses and the lack of nonobstructive atherosclerotic lesions, confers an excellent prognosis, while the detection of stenoses requires subsequent risk modification, possibly further ischemia diagnostics and potentially invasive management, depending on symptoms and anatomy. The identification of nonobstructive atherosclerosis indicates an increased cardiovascular risk, particularly if plaque burden is high. The threshold for the amount of atherosclerotic plaques to indicate when risk-modifying treatment should be initiated has, however, not yet been clarified by clinical data. Coronary CTA has limited clinical value in patients after prior revascularization and is currently not indicated for risk assessment in asymptomatic individuals due to the lack of sufficiently robust data. Coronary CTA can be useful to clarify cardiac and coronary anatomy prior to repeat bypass surgery or minimally invasive cardiac surgery procedures. This consensus statement outlines the technical requirements and clinical indications of coronary CTA and discusses its integration into patient management in cardiology and cardiac surgery.
Authors with CRIS profile
Involved external institutions
Universitätsklinikum Düsseldorf
Germany (DE)
Klinikum Fulda
Germany (DE)
Herzzentrum Leipzig
Germany (DE)
Herz- und Diabeteszentrum Nordrhein-Westfalen
Germany (DE)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
Universitätsklinikum Jena
Germany (DE)
Charité - Universitätsmedizin Berlin
Germany (DE)
Evangelisches Klinikum Niederrhein
Germany (DE)
Germany (DE)
Klinikum Fulda
Germany (DE)
Herzzentrum Leipzig
Germany (DE)
Herz- und Diabeteszentrum Nordrhein-Westfalen
Germany (DE)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
Universitätsklinikum Jena
Germany (DE)
Charité - Universitätsmedizin Berlin
Germany (DE)
Evangelisches Klinikum Niederrhein
Germany (DE)
How to cite
APA:
Achenbach, S., Smetak, N., Assmann, A., Dörge, H., Thiele, H., Gummert, J.,... Börgermann, J. (2026). Clinical role of computed tomography-based angiography of the coronary arteries (coronary CT-angiography) for cardiology and cardiac surgery 2026: Consensus paper of the German Cardiac Society (DGK) and the German Society for Thoracic, Cardiac and Vascular Surgery (DGTHG) Stellenwert der Computertomographie-basierten Angiographie der Koronararterien (koronare CT-Angiographie) für die Kardiologie und Herzchirurgie 2026: Konsensuspapier der Deutschen Gesellschaft für Kardiologie (DGK) und der Deutschen Gesellschaft für Thorax‑, Herz- und Gefäßchirurgie (DGTHG). Die Kardiologie. https://doi.org/10.1007/s12181-025-00785-1
MLA:
Achenbach, Stephan, et al. "Clinical role of computed tomography-based angiography of the coronary arteries (coronary CT-angiography) for cardiology and cardiac surgery 2026: Consensus paper of the German Cardiac Society (DGK) and the German Society for Thoracic, Cardiac and Vascular Surgery (DGTHG) Stellenwert der Computertomographie-basierten Angiographie der Koronararterien (koronare CT-Angiographie) für die Kardiologie und Herzchirurgie 2026: Konsensuspapier der Deutschen Gesellschaft für Kardiologie (DGK) und der Deutschen Gesellschaft für Thorax‑, Herz- und Gefäßchirurgie (DGTHG)." Die Kardiologie (2026).
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