Cardiology Research and Practice 3 ∗ Ao LV RV RA RV RA (b) ∗ Ao LV (a) Ao LA RA Ao RV LA (c) Figure 1: 48-year-old female with history of childhood lymphoma treated with mediastinal radiation therapy and anthracycline chemotherapy at age 12, presented with fatigue and decreased left ventricular ejection fraction by echocardiogram. Coronary CT angiography shows nonobstructive coronary plaques and supports the diagnosis of chemotherapy-induced cardiomyopathy. (a) Curved reformat view of the right coronary artery (RCA) shows nonocclusive calciﬁc ostial plaque (arrowheads) calciﬁc plaque in the aortic root. The ﬁrst acute marginal branch is identiﬁed (arrow). Also noted are misregistration artifacts. (b, c) Curved reformat views of the left anterior descending (LAD) (b) and circumﬂex (c) coronary arteries show calciﬁc plaque (white arrowhead) in the aortic root at the origin of the left main coronary artery. The ﬁrst diagonal artery (black arrowhead) is identiﬁed on the LAD view (b). The LAD origin (black arrow) and distal circumﬂex artery continuation (white arrow) are identiﬁed on the circumﬂex view (c). No signiﬁcant narrowing is seen in any of the major coronary arteries. LA = left atrium. LV = left ventricle. RA = right atrium. RV = right ventricle. Ao = Aortic root. ∗ = breast prosthesis. Medical management of CAD was deﬁned as treatment based on coronary calciﬁcation and/or the presence of plaque (which deﬁnes atherosclerotic disease and therefore identiﬁes more aggressive secondary prevention targets). CAD risk factor modiﬁcation was deﬁned as primary prevention step in absence of demonstrated CAD, which, for nondiabetic patients, has less stringent criteria. 3. Results Eighty CCTAs were performed during the ﬁrst year at our center. Baseline demographics, CAD risk factors and proportions of hematological malignancies are shown in Table 1. The mean age of the patient population was 58.8 ± 12.8 years with 56% males. Hypertension was found in 48% of the cases, hyperlipidemia in 36% of cases, diabetes mellitus in 13% and established CAD in 9% of cases. About 45% of patients had hematological malignancy (leukemia and lymphoma) whereas the rest had a solid tumor. The most common indication for obtaining a CCTA was LV dysfunction (41% of cases) followed by chest pain and or dyspnea in 40% of the cases (Table 2). About 20% CCTA was obtained for atypical symptoms with abnormal stress test and 10% were for atypical symptoms with abnormal biomarkers. Miscellaneous indications were present in 13 patients (16.3%), including suspected cardiac tumor and/or thrombus or pulmonary embolism. Indications were not mutually exclusive and some patients had more than one at the time of CCTA. Overall, 72 pts (90%) had at least one relative con- traindication to ICA (Table 3). The majority of the patients (61%) who underwent a CCTA had a low to moderate pretest probability for CAD. Concomitant radiation or chemotherapy was present in 25% of cases and rest (19%) had leucopenia and/or thrombocytopenia.