Cardiac magnetic resonance and computed tomography angiography for clinical imaging of stable coronary artery disease

Two non-invasive tests, two different strengths — this review frames cardiac MRI and CT angiography as complementary rather than competing tools for stable coronary disease.

The division of labor is clean: CT angiography excels at anatomy and plaque, showing the arteries and what lines them; MRI excels at function, showing how the heart muscle moves and whether it’s getting enough blood. Used together, the authors argue, they diagnose and risk-stratify stable CAD with a depth neither achieves alone — while honestly noting that neither yet fully replaces invasive angiography.

The practical takeaway is to play to each test’s strength to spare patients unnecessary invasive procedures. The resistance comes from interventional cardiologists and imaging traditionalists wary of workflow and reimbursement disruption.

We rate the evidence moderate: a heavily referenced (175 citations) review from respected, conflict-free academics, but a synthesis rather than new data — and now a decade old in a field that has moved quickly. Its clinical significance is moderate: a sensible non-invasive strategy, bounded by the fact that the modalities complement rather than supplant catheterization.