Document Detail


Impact of clinical presentation and pretest likelihood on the relation between calcium score and computed tomographic coronary angiography.
MedLine Citation:
PMID:  21055714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of the present study was to assess the impact of clinical presentation and pretest likelihood on the relation between coronary calcium score (CCS) and computed tomographic coronary angiography (CTA) to determine the role of CCS as a gatekeeper to CTA in patients presenting with chest pain. In 576 patients with suspected coronary artery disease (CAD), CCS and CTA were performed. CCS was categorized as 0, 1 to 400, and >400. On CT angiogram the presence of significant CAD (≥50% luminal narrowing) was determined. Significant CAD was observed in 14 of 242 patients (5.8%) with CCS 0, in 94 of 260 patients (36.2%) with CCS 1 to 400, and in 60 of 74 patients (81.1%) with CCS >400. In patients with CCS 0, prevalence of significant CAD increased from 3.9% to 4.1% and 14.3% in nonanginal, atypical, and typical chest pain, respectively, and from 3.4% to 3.9% and 27.3% with a low, intermediate, and high pretest likelihood, respectively. In patients with CCS 1 to 400, prevalence of significant CAD increased from 27.4% to 34.7% and 51.7% in nonanginal, atypical, and typical chest pain, respectively, and from 15.4% to 35.6% and 50% in low, intermediate, and high pretest likelihood, respectively. In patients with CCS >400, prevalence of significant CAD on CT angiogram remained high (>72%) regardless of clinical presentation and pretest likelihood. In conclusion, the relation between CCS and CTA is influenced by clinical presentation and pretest likelihood. These factors should be taken into account when using CCS as a gatekeeper for CTA.
Authors:
Jacob M van Werkhoven; Stephanie M de Boer; Joanne D Schuijf; Filippo Cademartiri; Erica Maffei; J Wouter Jukema; Mark J Boogers; Lucia J Kroft; Albert de Roos; Jeroen J Bax
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-04
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  2011-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1675-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, Leiden University Medical Center, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Calcinosis / epidemiology,  metabolism,  radiography*
Calcium / metabolism*
Coronary Angiography / methods*
Coronary Artery Disease / epidemiology,  metabolism,  radiography*
Coronary Vessels / metabolism*
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Male
Middle Aged
Netherlands / epidemiology
Prevalence
Prospective Studies
Reproducibility of Results
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
7440-70-2/Calcium

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


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