Publication Name	World Journal of Cardiology
Manuscript ID	127371
DOI	10.4330/wjc.127371
Country	Australia

Category	Cardiac & Cardiovascular Systems
Manuscript Type	Retrospective Study
Article Title	Vessel-level patterns and predictors of discordance between computed tomography coronary angiography and invasive coronary angiography
Manuscript Source	Invited Manuscript
All Author List	Sisijaya Vinura Jayawardena, Edwin Hsiang Win Foo, Simon Angus Savage, Yash Pradeep Patwardhan, Kristoffer Ken Ralota, Jamie Layland and Rohit Samuel
Funding Agency and Grant Number
Corresponding Author	Sisijaya Vinura Jayawardena, MD, Cardiology, Peninsula Health, 2 Hastings Rd, Frankston VIC 3199, Frankston 3199, Victoria, Australia. j.vinura@gmail.com
Key Words	Computed tomography coronary angiography; Invasive coronary angiography; Coronary artery disease; Diagnostic discordance; Coronary calcium burden; Stenosis severity; Epicardial vessels; Mixed-effects modelling
Core Tip	In this selected real-world cohort undergoing paired computed tomography coronary angiography (CTCA) and invasive coronary angiography (ICA), greater visual patient-level coronary calcium burden was associated with discordance at both patient and vessel levels, confirming a recognised limitation of CTCA in calcified disease. Discordance varied substantially by epicardial territory, with the left anterior descending artery showing the highest and left main coronary artery the lowest observed rates. These findings are consistent with treating a severe CTCA result as the beginning of a clinical decision process rather than as an automatic indication for ICA: The anatomical abnormality should be reconciled with symptoms and overall clinical context, with functional assessment considered where appropriate and ICA used when invasive clarification is clinically warranted. The territory-specific pattern and hierarchical analysis add descriptive information beyond the established calcium effect, but these findings are hypothesis-generating and require external validation with blinded reproducibility assessment, quantitative calcium measurement, and physiological or intravascular correlation.
Citation	Jayawardena SV, Foo EHW, Savage SA, Patwardhan YP, Ralota KK, Layland J, Samuel R. Vessel-level patterns and predictors of discordance between computed tomography coronary angiography and invasive coronary angiography. World J Cardiol 2026; In press DOI: https://doi.org/10.4330/wjc.127371
PDF	127371-in-press.pdf

Received	2026-08-28 02:33
Peer-Review Started	2026-08-28 02:33
First Decision by Editorial Office Director
Return for Revision	2026-09-16 08:35
Revised	2026-10-09 00:20
Publication Fee Transferred
Second Decision by Editor	2026-11-02 02:18
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-11-02 02:41
Articles in Press	2026-11-02 02:41
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1949-8462 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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