n conclusion, the totality of the evidence does not support endorsing CCTA as the noninvasive test of choice in evaluating patients with stable chest pain. Arguably, there is only 1 trial with favorable, albeit not robust, outcome data8; however, the quality and the quantity of evidence is not sufficient to justify the imprimatur of Class I recommendation of the ACC/AHA guidelines. At best, CCTA can be deemed an alternative to standard care (including conventional stress testing) in these patients. Any claim to the contrary is perhaps a case of enthusiasm exceeding the evidence.

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