CT Stress Myocardial Perfusion, Fractional Flow Reserve and Angiography in Patients With Stable Chest Pain Syndromes

Who May Qualify: - Chest pain in patients with clinically suspected or confirmed ischemic heart disease - Clinical indication for non-acute coronary evaluation - Status of coronary revascularization 1. With previous coronary revascularization - all patients 2. Without previous coronary revascularization 1. Age≥65 years - all patients with chest pain 2. Age\>50 - \<65 years - typical angina pectoris and at least one cardiovascular risk factor and/or previous myocardial infarction - Typical angina requiring all 3 criteria present: a) constrictive discomfort in the front of the chest or in the neck, jaw, shoulder or arm, b) precipitated by physical exertion c) relieved by rest or nitrates within 5 min. - Cardiovascular risk factors: hypertension, diabetes, hypercholesterolemia, current smoking, family history of ischemic heart disease, previous stroke, peripheral artery disease Who Should NOT Join This Trial: - Persistent chest pain and signs of ongoing acute myocardial ischemia requiring acute coronary intervention - Hospitalization and discharge with the confirmed diagnosis acute coronary syndrome (STEMI or NSTEMI) within the last 6 months - Severe valvular heart disease as primary diagnosis and/or in potential need of percutaneous or surgical valve treatment - Known severe heart failure (LVEF less than 35%) - Language, cultural or mental factors preventing the patient from understanding the willing to sign a consent form form - Known atrial fibrillation - Known renal impairment (estimated Glomerular Filtration Rate below \<30 ml/min) - Known x-ray contrast allergy - Known intolerance to adenosine infusion Always talk to your doctor about whether this trial is right for you.