Aims: To evaluate 64 slice multi-detector dual-source coronary computed tomography (CT) for the determination of the appropriate therapeutic strategy in patients with suspected coronary artery disease (CAD) Methods and results: CT angiography was performed in 313 patients with stable angina (191 male, age 68.7 짹 6.9 years) for elective coronary angiography. Both techniques were used to evaluate the presence of CAD, significant stenosis and the need for revascularization therapy. Sensitivity and specificity for the presence of significant stenosis were 93.2% (260/279) and 67.6% (23/34) for patients, and 77.9% (522/671) and 86.1% (500/581) for arteries, respectively. In therapeutic decision-making based on CT angiography, sensitive, specificity, positive and negative predictive values for intervention were 94.8% (236/249), 65.0% (39/60), 91.5% (236/258) and 39/60 (65.0%), respectively. Coronary CT predicted in 87.9% of the patients the appropriate therapeutic strategy, medical treatment or revascularization. If revascularization was needed, the appropriate therapeutic strategy, percutaneous coronary intervention or coronary bypass surgery, were in 68.1% of patients. Conclusions: Although imaging modality and qualities have improved, CT angiography cannot be used for definitive decision-making with regard to revascularization procedures in patients with stable angina.