The role of coronary artery calcification score in clinical practice.
BACKGROUND
Coronary artery calcification (CAC) measured by electron-beam computed tomography (EBCT) has been well studied in the prediction of coronary artery disease (CAD). We sought to evaluate the impact of the CAC score in the diagnostic process immediately after its introduction in a large tertiary referral centre.


METHODS
598 patients with no history of CAD who underwent EBCT for evaluation of CAD were retrospectively included into the study. Ischemia detection test results (exercise stress test, single photon emission computed tomography or ST segment analysis on 24 hours ECG detection), as well as the results of coronary angiography (CAG) were collected.


RESULTS
The mean age of the patients was 55 +/- 11 years (57% male). Patients were divided according to CAC scores; group A < 10, B 10 - 99, C 100 - 399 and D >or= 400 (304, 135, 89 and 70 patients respectively). Ischemia detection tests were performed in 531 (89%) patients; negative ischemia results were found in 362 patients (183 in group A, 87 in B, 58 in C, 34 in D). Eighty-eight percent of the patients in group D underwent CAG despite negative ischemia test results, against 6% in group A, 16% in group B and 29% in group C. A positive ischemia test was found in 74 patients (25 in group A, 17 in B, 16 in C, 16 in D). In group D 88% (N = 14) of the patients with a positive ischemia test were referred for CAG, whereas 38 - 47% in group A-C.


CONCLUSIONS
Our study showed that patients with a high CAC score are more often referred for CAG. The CAC scores can be used as an aid in daily cardiology practice to determine further decision making.
Piers
Lieuwe H
LH
Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands. l.h.piers@thorax.umcg.nl
Salachova
Farah
F
Slart
Riemer H J A
RH
Vliegenthart
Rozemarijn
R
Dikkers
Riksta
R
Hospers
Frederique A P
FA
Bouma
Hjalmar R
HR
Zeebregts
Clark J
CJ
Willems
Tineke P
TP
Oudkerk
Matthijs
M
Zijlstra
Felix
F
Tio
René A
RA
D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000175:diagnosis* / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*