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The consistency of this study with data from randomised trials and observational registries leads us to agree that computed tomography has primacy as gatekeeper for the cardiac catheter laboratory irrespective of the level of pre-test probability. This latest addition to the growing and large body of evidence does beg the question of why guidelines do not now recommend CCTA as the first line test of choice for the non-invasive investigation of all patients with stable coronary artery disease? Crown All rights reserved.BACKGROUND Although c