| 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:
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PMID: 19760230 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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:
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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:
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Type: Journal Article Date: 2009-09-16 |
Journal Detail:
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Title: European radiology Volume: 20 ISSN: 1432-1084 ISO Abbreviation: Eur Radiol Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-10 Completed Date: 2010-06-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9114774 Medline TA: Eur Radiol Country: Germany |
Other Details:
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Languages: eng Pagination: 846-54 Citation Subset: IM |
Affiliation:
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Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy. filippocademartiri@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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