Coronary artery diseasePrevalence and Extent of Obstructive Coronary Artery Disease in Patients With Zero or Low Calcium Score Undergoing 64-Slice Cardiac Multidetector Computed Tomography for Evaluation of a Chest Pain Syndrome
Section snippets
Methods and Results
In 668 patients with chest pain symptoms who were referred for noninvasive diagnostic multidetector computed tomographic coronary angiography over a 15-month period, we identified 231 (38% with acute presentation, 62% with long-term presentation) with a 0 (n = 125) or low (n = 106) coronary calcium score (CS). A low CS was defined as an Agatston score of 1 to 100 because a CS of 100 is an often used cut-off point for risk assessment. We also analyzed data separately in the patient subset with a
Discussion
Obstructive coronary lesions were detected by contrast-enhanced MDCT in 7% of patients with a 0 CS and in 17% with a low CS (9% with a CS of 0 to 10). These lesions were clinically important and involved the LAD in almost 66% of patients and the left main artery in 1, necessitating a myocardial revascularization procedure in 7% of patients overall. The study established that in symptomatic patients a 0 or low CS on computed tomogram cannot be used to exclude an acute or long-term coronary
References (14)
- et al.
Computed tomography of the coronary arteries: more than meets the (angiographic) eye
J Am Coll Cardiol
(2005) - et al.
Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography
J Am Coll Cardiol
(2005) - et al.
Diagnosis of coronary in-stent restenosis with multi-detector row computed tomography
J Am Coll Cardiol
(2005) - et al.
Comparison of coronary calcium in stable angina pectoris and in first acute myocardial infarction utilizing double helical computerized tomography
Am J Cardiol
(1998) - et al.
Advances in cardiac CT imaging: 64-slice scanner
Int J Cardiovasc Imaging
(2004) - et al.
High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography
Circulation
(2005) - et al.
Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris
Eur Radiol
(2006)
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