Clinical utility of coronary calcium scoring after nonischemic myocardial perfusion imaging.
BACKGROUND
Coronary artery calcium (CAC) scoring is increasingly being used after myocardial perfusion imaging (MPI) to detect preclinical coronary artery disease (CAD). However, there are few data to support this approach.


RESULTS
We reviewed 200 consecutive patients without known CAD who were referred for CAC scoring shortly after nonischemic MPI. Of these, 13 (6.5%) had CAC scores greater than 400, indicating significant CAD; 22 (11%) had CAC scores of 101 to 400; 27 had CAC scores of 11 to 100; and the remainder (n = 138) has CAC scores of 1 to 10. Traditional risk factors and patient characteristics were not significant predictors of CAC scores of 101 or greater. However, age and the Framingham risk score were predictors of CAC scores greater than 0. At follow-up, significantly more patients with CAC scores of 101 or greater had been given the advice to take lipid-lowering medication and aspirin compared with those with CAC scores of 0.


CONCLUSIONS
Of patients referred for CAC scoring after nonischemic MPI, 17.5% were identified as having CAD based on a CAC score greater than 100, allowing intervention with aggressive medical therapy. Patients who were reclassified were not easily identifiable by traditional risk factors, but Framingham risk score did predict the presence of CAC. Clinicians modified medical therapy based on the results of CAC scoring.
Thompson
Randall C
RC
Cardiovascular Consultants PC, 4330 Wornall Road, Suite 2000, Kansas City, MO 64111, USA. rthompson@cc-pc.com
McGhie
A Iain
AI
Moser
Kevin W
KW
O'Keefe
James H
JH
Stevens
Tracy L
TL
House
John
J
Fritsch
Nicolas
N
Bateman
Timothy M
TM
D017677:Age Distribution; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000378:metabolism; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000378:metabolism; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000378:metabolism; D011379:Prognosis; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D013223:Statistics as Topic
D002118:Calcium