Seasonal patterns in diagnosis of coronary artery disease by CT-angiography—experience from a large real-world cohort
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By
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Karl Finke
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Stephan Nienaber
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Carsten Gietzen
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Lenhard Pennig
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Marcel Halbach
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Jan Althoff
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Stephan Baldus
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Hendrik Wienemann
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Sebastian Schäfer
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July 14, 2026
Clinical Scorecard: Seasonal Variations in Coronary Artery Disease Diagnoses via CT Angiography: Insights from a Large Real-World Study
At a Glance
| Category | Detail |
|---|
| Condition | Coronary Artery Disease (CAD) |
| Key Mechanisms | Seasonal variations influence incidence and outcomes of acute coronary syndromes, with increased cardiovascular risk factors in colder months. |
| Target Population | Patients with intermediate pre-test probability of CAD presenting with chest pain or dyspnea. |
| Care Setting | Outpatient CCTA practice integrated in a cardiology practice with a certified chest pain clinic. |
Key Highlights
- Higher incidence of acute coronary syndromes in winter months.
- CCTA is recommended as a first-line diagnostic strategy for CAD.
- Seasonal changes may affect the presentation of CAD without ACS.
Guideline-Based Recommendations
Diagnosis
- CCTA is recommended for evaluation of chest pain patients with low to intermediate pre-test probability of CAD.
Management
- New medical therapy initiation includes lipid-lowering therapy, antithrombotic medication, or antianginal medication.
Monitoring & Follow-up
- Regular documentation of quality management data for CCTA examinations.
Risks
- Increased cardiovascular risk factors and sympathetic activation in colder months.
Patient & Prescribing Data
Patients undergoing CCTA with symptoms suggestive of CAD.
New medical therapy may be initiated based on CCTA findings.
Clinical Best Practices
- Utilize CCTA for accurate diagnosis of obstructive and non-obstructive CAD.
- Ensure adequate heart rate control and image quality prior to CCTA.
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