State of Overall Cardiovascular Risk and Imaging Strategies in India

Noninvasive cardiac imaging has undergone a recent resurgence in India with the development of new approaches for imaging coronary atherosclerosis. Noncontrast computed tomography (CT) for imaging the extent of coronary artery calcification (CAC) and contrast CT for noninvasive coronary angiography (CTA) are developments with a growing evidence base regarding risk assessment and the diagnosis of obstructive coronary disease. Stress myocardial perfusion SPECT (MPS) is the most commonly used stress imaging technique for patients with suspected or known coronary disease, which is slowly gaining popularity in urban India. In contrast to the nascent evidence noted with coronary CTA, MPS has a robust evidence base, including the support of numerous clinical guidelines. It is likely that assessing the extent of atherosclerosis using CAC or coronary CTA will become an increasing part of mainstream cardiovascular imaging practices.