Document Detail

Meaning of zero coronary calcium score in symptomatic patients referred for coronary computed tomographic angiography.
MedLine Citation:
PMID:  22461571     Owner:  NLM     Status:  MEDLINE    
AIMS: The clinical implication of a zero coronary calcium score (CCS) in patients with chest pain syndrome has been under debate. This study was undertaken to determine the meaning of a CCS of zero in a large sample of symptomatic patients referred for coronary computed tomographic (CT) angiography.
METHODS AND RESULTS: We consecutively enrolled 2088 patients (age 58 ± 10 years, 1028 men) who had undergone 64-slice cardiac CT due to chest pain syndrome. A CCS of zero was detected in 1114 patients (471 men and 643 women). Of these 1114 patients, obstructive coronary artery disease (CAD) was found in a total of 48 patients (4.3%); 35 men (7.4%) and 13 women (2.0%). Among the zero CCS patients with obstructive CAD, men had a higher prevalence of both premature CAD (49 vs. 0%) and multivessel disease (20 vs. 8%) than women. During the follow-up period (1033 ± 136 days), early revascularization was done in 25 patients (2.2%, 18 men and 7 women) and there were 14 major adverse cardiac events (1.3%, 8 men and 7 women) among the zero CCS patients. CAD severity was a strong prognostic indicator in the zero CCS patients.
CONCLUSION: A CCS of zero cannot be used by itself to exclude obstructive CAD in symptomatic patients referred for coronary CT angiography (CCTA). The prevalence of obstructive CAD and adverse cardiac events are not negligible in symptomatic patients with a CCS of zero, and CAD severity by CCTA is associated with higher rates of adverse cardiac event.
Young Jin Kim; Jin Hur; Hye-Jeong Lee; Hyuk-Jae Chang; Ji Eun Nam; Yoo Jin Hong; Hee Young Kim; Ji Won Lee; Byoung Wook Choi
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-03-29
Journal Detail:
Title:  European heart journal cardiovascular Imaging     Volume:  13     ISSN:  2047-2412     ISO Abbreviation:  Eur Heart J Cardiovasc Imaging     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-09     Completed Date:  2013-01-07     Revised Date:  2013-02-20    
Medline Journal Info:
Nlm Unique ID:  101573788     Medline TA:  Eur Heart J Cardiovasc Imaging     Country:  England    
Other Details:
Languages:  eng     Pagination:  776-85     Citation Subset:  IM    
Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
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MeSH Terms
Aged, 80 and over
Calcinosis / radiography*
Cardiac-Gated Imaging Techniques
Chest Pain / radiography*
Chi-Square Distribution
Contrast Media / diagnostic use
Coronary Angiography / methods*
Coronary Artery Disease / radiography*
Iopamidol / diagnostic use
Middle Aged
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Tomography, X-Ray Computed / methods*
Reg. No./Substance:
0/Contrast Media; 62883-00-5/Iopamidol
Comment In:
Eur Heart J Cardiovasc Imaging. 2013 Feb;14(2):193-4   [PMID:  23129432 ]
Eur Heart J Cardiovasc Imaging. 2013 Feb;14(2):193   [PMID:  23136445 ]

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