Introduction: The primary goal of this retrospective study was to assess the use of Multi-Slice Computed Tomography (MSCT) coronary angiography in comparison with conventional invasive coronary angiography for the detection of significant coronary artery disease (CAD) at Dubrava University Hospital over a one-year period.

Patients and Methods: From February 2022 to February 2023, 283 patients with symptoms of coronary artery disease were scheduled to undergo MSCT coronary angiography; however, 12 were found to have contraindications for the procedure due to arrhythmia and chronic kidney disease.

Results: In total, CT coronary angiography was performed on 271 patients, of whom 86 tested positive for coronary artery disease and required conventional coronary angiography. Notably, only 36% (31 patients) had significant coronary disease that necessitated intervention or functional assessment of coronary stenosis.

Conclusion: Although MSCT coronary angiography is a non-invasive and cost-effective method for evaluating coronary artery disease—with the added advantage of imaging plaque compositions—it demonstrated a tendency to overestimate the degree of stenosis, leading to false-positive results. (1) Consequently such overestimations can result in unnecessary follow-up procedures, increased healthcare costs, and potential patient anxiety.