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May 25, 2005

Noninvasive Coronary Angiography: Hype or New Paradigm?

Author Affiliations

Author Affiliations: Cardiovascular Imaging Section, Departments of Cardiology and Radiology, Cleveland Clinic Foundation, Cleveland, Ohio.

JAMA. 2005;293(20):2531-2533. doi:10.1001/jama.293.20.2531

When Sones inadvertently performed the first coronary angiogram in 1958,1 he could not anticipate the profound future implications of that event. Four years later, when he reported his experience with more than 1000 procedures,2 the technique was still considered experimental and was dismissed by many leading authorities in cardiovascular medicine. Yet, the introduction of coronary angiography started a new era, leading to the rapid development of coronary artery bypass graft surgery and percutaneous revascularization for the routine management of ischemic heart disease. Four decades later, more than 2 million angiographic procedures are performed annually in the United States alone.3 Although invasive coronary angiography clearly has led to improved outcomes, it also has contributed to greater expenses in health care cost,3 limiting its potential to become more widely available. This has led to a growing interest in the scientific community in the development of less expensive, noninvasive alternative methods for evaluating coronary anatomy.