Suspected Coronary Artery Disease (CAD) and its clinical consequences are the leading cause of death and disability in Western Countries and thus its prevention is important for both ethical and economic reasons. Although traditional risk charts may provide risk stratification in the overall population, their ability to predict the first cardiac event at the individual patient level is limited. Important progress has been made over the last 10 years in the field of non-invasive coronary imaging. All imaging techniques, including stress echocardiography, nuclear medicine, stress cardiac magnetic resonance (CMR), and positron emission tomography have implemented specific software able to guarantee high diagnostic accuracy. In particular, coronary computed tomography angiography (CCTA) is an emerging non-invasive technique for the evaluation of CAD. The anatomic evaluation of coronary vessels by this technique has the potential to non-invasively characterize coronary atherosclerotic plaques at high risk of acute coronary syndrome. Moreover, CCTA has emerged as a unique technique providing coronary arteries anatomy and functional relevance of CAD in a single shot scan due to the recent introduction of stress-CT and non-invasive fractional flow reserve (FFR-CT).

For many years, invasive coronary angiography was considered the reference standard, and myocardial revascularization was guided exclusively by visual assessment of coronary stenoses without taking into consideration their functional significance. Over time, non-invasive functional imaging modalities have been used as gatekeepers to invasive coronary angiography, but the diagnostic accuracy remains unfortunately low-to-moderate. Indeed, despite the fact that severe coronary lesions are more likely to cause ischemia, there may be a mismatch between the anatomic severity of lesions and the presence of myocardial ischemia that would benefit from intervention. The appropriateness of diagnostic techniques for the diagnosis of suspected CAD is indicated by the recent international guidelines. At the onset of 2016, the National Institute for Health and Care Excellence (NICE) published an update to its guideline on chest pain, providing physicians with significant changes to the 2010 version. Importantly, the European Society of Cardiology updated the guidelines in 2019, dramatically revolutionizing the previous approach to patients with suspected stable CAD.

This Special Issue invites authors to contribute original research articles as well as review articles related to coronary artery disease, stable ischemic heart disease, and imaging diagnostic techniques implementation. To underscore new insights from any imaging diagnostic techniques, we encourage highlighting the aspects of primary prevention, diagnostic accuracy, and prognosis.

Potential topics include but are not limited to the following:

• Coronary atherosclerosis
• Cardiovascular risk assessment in asymptomatic patient
• Use of echocardiography, nuclear medicine, cardiac magnetic resonance, and cardiac computed tomography for the diagnosis of CAD in symptomatic patient
• Myocardial ischemia
• New technology (software) for diagnosis of CAD
• Prognostic stratification of patients with or without known ischemic heart disease
• Integrating the role of cardiology and radiology for the evaluation of ischemic cardiomyopathy
• Interpretation of recent International Guidelines for suspected stable CAD
• Application and perspectives of machine learning and deep learning in CAD