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Specific recommendations are provided for further management of patients with stable or acute chest pain based on the CAD&#8208;RADS classification&#46; The main goal of CAD&#8208;RADS is to standardize reporting of coronary CTA results and to facilitate communication of test results to referring physicians along with suggestions for subsequent patient management&#46; In addition&#44; CAD&#8208;RADS will provide a framework of standardization that may benefit education&#44; research&#44; peer&#8208;review and quality assurance with the potential to ultimately result in improved quality of care&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Coment&#225;rio</span><p id="par0020" class="elsevierStylePara elsevierViewall">Na &#250;ltima d&#233;cada&#44; a coronariografia por tomografia computadorizada &#40;AngioTC coron&#225;ria&#41; imp&#244;s&#8208;se no armament&#225;rio diagn&#243;stico ao dispor do cardiologista&#46; A sua elevada sensibilidade e excelente valor preditivo negativo transformaram&#8208;na no principal m&#233;todo de escolha para exclus&#227;o de doen&#231;a coron&#225;ria em pacientes com probabilidade interm&#233;dia&#8208;baixa&#44; nomeadamente ap&#243;s uma prova de esfor&#231;o eletricamente positiva ou ap&#243;s testes funcionais discordantes com a cl&#237;nica&#46; V&#225;rios grandes estudos demonstraram a utilidade cl&#237;nica da AngioTC coron&#225;ria&#44; incluindo os recentes estudos prospetivos multic&#234;ntricos PROMISE e SCOT&#8208;HEART e quatro ensaios cl&#237;nicos aleatorizados&#58; CT&#8208;STAT&#44; ACRIN&#8208;PA&#44; ROMICAT II&#44; e CT&#8208;COMPARE&#46; No entanto&#44; at&#233; &#224; data&#44; n&#227;o havia uma refer&#234;ncia estandardizada de comunica&#231;&#227;o dos resultados de um exame de AngioTC coron&#225;rio&#44; o que potencia uma certa subjetividade de interpreta&#231;&#227;o e&#44; para o m&#233;dico referenciador&#44; dificuldades acrescidas em termos de orienta&#231;&#227;o cl&#237;nica p&#243;s&#8208;teste&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Baseando&#8208;se em casos de sucesso de outras &#225;reas da medicina&#44; como a mamografia e a imagiologia do f&#237;gado ou do pulm&#227;o&#44; em que a implementa&#231;&#227;o de um sistema padronizado melhorou muito a comunicabilidade entre cl&#237;nicos e a ado&#231;&#227;o de medidas p&#243;s&#8208;teste adequadas&#44; as tr&#234;s principais sociedade m&#233;dicas da &#225;rea &#40;<span class="elsevierStyleItalic">Society for Cardiovascular Computed Tomography</span> &#91;SCCT&#93;&#44; <span class="elsevierStyleItalic">American College of Radiology</span> &#91;ACR&#93; e <span class="elsevierStyleItalic">North American Society for Cardiovascular Imaging</span> &#91;NASI&#93;&#41; desenvolveram um documento de consenso que viria a ser endossado pelo <span class="elsevierStyleItalic">American College of Cardiology</span> e que visa a padroniza&#231;&#227;o de relat&#243;rios para a angiografia coron&#225;ria &#40;CCTA&#41;&#44; como forma a melhorar a interpreta&#231;&#227;o dos resultados e a orienta&#231;&#227;o terap&#234;utica subsequente&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A classifica&#231;&#227;o CAD&#8208;RADS segue uma l&#243;gica de aplica&#231;&#227;o &#171;por paciente&#187; e representa a les&#227;o coron&#225;ria com maior grau de estenose documentada pela AngioTC coron&#225;ria&#44; apresentando &#171;modificadores&#187; que facilitam a descri&#231;&#227;o da coronariografia de pacientes com <span class="elsevierStyleItalic">stents</span> e&#47;ou revasculariza&#231;&#227;o cir&#250;rgica pr&#233;via&#46; Os autores recomendam que a classifica&#231;&#227;o seja anunciada como parte integrante da conclus&#227;o do relat&#243;rio de AngioTC coron&#225;rio&#44; fornecendo recomenda&#231;&#245;es espec&#237;ficas de orienta&#231;&#227;o p&#243;s&#8208;teste&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Espera&#8208;se que este documento contribua para uma melhor utiliza&#231;&#227;o da t&#233;cnica e rentabiliza&#231;&#227;o de todas as suas potencialidades&#44; pelo que &#233; imprescind&#237;vel que seja adotado de forma generalizada&#44; e que os cl&#237;nicos se familiarizem com a nova classifica&#231;&#227;o e as suas implica&#231;&#245;es em termos de orienta&#231;&#227;o cl&#237;nica&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0040" class="elsevierStylePara elsevierViewall">O autor declara n&#227;o haver conflito de interesses&#46;</p></span></span>"
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