Dobutamine stress echocardiography in patients with moderate coronary artery disease detected by coronary computed tomography angiography could reduce the rate of unnecessary coronary angiography.

The addition of DSE in case of abnormal CCTA increases significantly the negative predictive value for detecting significant CAD in need for revascularisation and thus reduces markedly the number of unnecessary CA. This diagnostic strategy has a higher diagnostic accuracy and negative predictive value to the opposite approach where an abnormal CCTA mandates a CA without additional functional testing.