Seasonal patterns in diagnosis of coronary artery disease by CT-angiography-experience from a large real-world cohort.

Authors

Karl Finke, Stephan Nienaber, Carsten Gietzen, Lenhard Pennig, Marcel Halbach, Jan Althoff, Stephan Baldus, Hendrik Wienemann, Sebastian Schäfer

Published in

Clinical research in cardiology : official journal of the German Cardiac Society. Jul 14, 2026. Epub Jul 14, 2026.

Abstract

The seasonal influence on acute coronary syndromes is well established with higher incidence and worse outcomes in winter. Data on the impact of seasonal changes on the diagnosis of non-acute coronary artery disease (CAD) are limited. The aim of this study was to evaluate the influence of seasons on the diagnosis of CAD by coronary CT-angiography (CCTA).
Data from a CCTA practice were retrospectively analyzed (2020-2025). The following parameters were compared for each season: any CAD defined as the presence of atherosclerotic plaques and obstructive CAD defined as a stenosis ≥ 50% in CCTA, initiation of new medical therapy, and initiation of invasive coronary angiography (ICA) based on CCTA.
In 10,023 CCTA cases, any CAD was diagnosed in 61.5% and obstructive CAD in 33.4% of patients. For obstructive CAD, the proportion varied only slightly across seasons, with rates of 35.1%, 34.1%, 31.4%, and 32.6% from spring to winter, respectively. Although the chi-square test indicated a nominal difference across seasons (p = 0.033), this was not confirmed in the regression analysis. Seasonal differences were observed in ICA initiation (spring to winter, 10.6%, 9.7%, 8.5%, 7.9%, p = 0.004), which was more likely during spring (OR 1.38 CI 95% 1.14-1.67, p < 0.001; reference, winter).
In this large retrospective real-world cohort, the first-time diagnosis of obstructive CAD by CCTA showed only small seasonal differences. ICA was initiated modestly more often in spring than in winter. These findings should be considered hypothesis-generating and may reflect clinical, organizational, or referral-related factors rather than a direct seasonal effect.

PMID:
42446585
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.

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