April 2022

Coronary artery disease (CAD) is one of the major causes of mortality and morbidity worldwide, with a high socioeconomic impact. Noninvasive imaging modalities play a fundamental role in the evaluation and management of patients with known or suspected CAD. Imaging endpoints have served as surrogate markers in many observational studies and randomized clinical trials that evaluated the benefits of specific therapies for CAD. A number of guidelines and recommendations have been published about coronary syndromes by cardiology societies and associations but have not focused on the excellent opportunities with cardiac imaging. The recent European Society of Cardiology (ESC) 2019 guideline on chronic coronary syndromes (CCS) and 2020 guideline on acute coronary syndromes (ACS) in patients presenting with non-ST-segment elevation (NSTE-ACS) highlight the importance of non-invasive imaging in the diagnosis, treatment, and risk assessment of the disease. The purpose of the current recommendations is to present the significant role of noninvasive imaging in coronary syndromes in more detail.