Document Detail


Coronary calcium score and computed tomography coronary angiography in high-risk asymptomatic subjects: assessment of diagnostic accuracy and prevalence of non-obstructive coronary artery disease.
MedLine Citation:
PMID:  19760230     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of the study was to compare the coronary artery calcium score (CACS) and computed tomography coronary angiography (CTCA) for the assessment of non-obstructive/obstructive coronary artery disease (CAD) in high-risk asymptomatic subjects. METHODS: Two hundred and thirteen consecutive asymptomatic subjects (113 male; mean age 53.6 +/- 12.4 years) with more than one risk factor and an inconclusive or unfeasible non-invasive stress test result underwent CACS and CTCA in an outpatient setting. All patients underwent conventional coronary angiography (CAG). Data from CACS (threshold for positive image: Agatston score 1/100/1,000) and CTCA were compared with CAG regarding the degree of CAD (non-obstructive/obstructive; </>or=50% lumen reduction). RESULTS: The mean calcium score was 151 +/- 403 and the prevalence of obstructive CAD was 17% (8% one-vessel and 10% two-vessel disease). Per-patient sensitivity, specificity, positive and negative predictive values of CACS were: 97%, 75%, 45%, and 100%, respectively (Agatston >or=1); 73%, 90%, 60%, and 94%, respectively (Agatston >or=100); 30%, 98%, 79%, and 87%, respectively (Agatston >or=1,000). Per-patient values for CTCA were 100%, 98%, 97%, and 100%, respectively (p < 0.05). CTCA detected 65% prevalence of all CAD (48% non-obstructive), while CACS detected 37% prevalence of all CAD (21% non-obstructive) (p < 0.05). CONCLUSION: CACS proved inadequate for the detection of obstructive and non-obstructive CAD compared with CTCA. CTCA has a high diagnostic accuracy for the detection of non-obstructive and obstructive CAD in high-risk asymptomatic patients with inconclusive or unfeasible stress test results.
Authors:
Filippo Cademartiri; Erica Maffei; Alessandro Palumbo; Sara Seitun; Chiara Martini; Carlo Tedeschi; Ludovico La Grutta; Massimo Midiri; Annick C Weustink; Nico R Mollet; Gabriel P Krestin
Publication Detail:
Type:  Journal Article     Date:  2009-09-16
Journal Detail:
Title:  European radiology     Volume:  20     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-10     Completed Date:  2010-06-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  846-54     Citation Subset:  IM    
Affiliation:
Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy. filippocademartiri@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Calcinosis / epidemiology*,  radiography*
Coronary Angiography / statistics & numerical data*
Coronary Artery Disease / epidemiology*,  radiography*
Female
Humans
Italy / epidemiology
Male
Middle Aged
Prevalence
Risk Assessment
Risk Factors
Tomography, X-Ray Computed / statistics & numerical data*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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