Abstract

Chest pain and coronary artery disease (CAD) impose a substantial burden on public health and society. Diagnostic imaging tests are used by clinicians to identify the presence and extent of epicardial coronary disease and/or its consequences, including ischaemia, infarction, and left ventricular dysfunction. In this article, we discuss current practice guideline recommendations for the diagnosis and management of patients with suspected or known CAD, and the need for more evidence from clinical trials. We then focus on the recently published and ongoing multicentre clinical trials of imaging-based strategies for the diagnosis and management of ischaemic heart disease, and the potential future impact of these trials on clinical practice. The results of these trials have the potential to bring radical changes to the practice of cardiology in the future.