Coronary disease & ACSCohort study
Radiation burden of contemporary diagnostic pathways for chronic coronary syndromes: an ancillary analysis of the international EURECA Imaging Registry
- sub-analysis of the prospective, multicentre EURECA Imaging registry
- 24 countries
Authors' conclusion
Cumulative radiation exposure in CCS varies substantially according to diagnostic strategy and practice patterns. Non-invasive, guideline-adopting pathways are associated with lower radiation burden, whereas ICA-first approaches lead to higher exposure. Optimizing test selection and promoting guidelines adoption may improve radiation safety in cardiovascular imaging.
Study context
- Population
- Patients with suspected chronic coronary syndromes (CCS) undergoing at least one ionizing imaging testout of 2306 with available radiation data
- Participants
- 2,058 patients
- Exposure
- Initial testing strategy: Single-photon emission computed tomography (SPECT)-first and computed tomography coronary angiography (CTCA)-first vs invasive coronary angiography (ICA)-first
Main finding
As reported in the abstract
Median cumulative effective dose (ED) by initial testing strategy
- Median cumulative effective dose (ED) differed significantly according to initial testing strategy
- P < 0.001
Observational data: associations, not effects.
Further findings
Inter-regional variability
- Marked inter-regional variability across all modalities, highest doses generally in Eastern and Southern European countries
Guideline-adopting diagnostic pathways
- Significantly lower cumulative ED in several regions
Predictors of radiation exposure (multivariable analysis)
- Hypertension, obesity, former smoking, and family history of coronary artery disease independently associated with higher radiation exposure
- all p < 0.01
- Female sex, non-anginal symptoms, and guideline adoption predicted lower ED
- all p < 0.01
Original publication
Radiation burden of contemporary diagnostic pathways for chronic coronary syndromes: an ancillary analysis of the international EURECA Imaging Registry. Eur Heart J Cardiovasc Imaging. Published 28 September 2026. doi:10.1093/ehjci/jeag274
Summarised from the published abstract; every number is checked against it