title: Diagnostic accuracy of computed tomography coronary angiography in patients with a zero calcium score.
abstract: To evaluate the diagnostic accuracy of 64-slice CT coronary angiography (CT-CA) for the detection of significant coronary artery stenosis in patients with zero on the Agatston Calcium Score (CACS). We enrolled 279 consecutive patients (96 male, mean age 48 +/- 12 years) with suspected coronary artery disease. Patients were symptomatic (n = 208) or asymptomatic (n = 71), and underwent conventional coronary angiography (CAG). For CT-CA we administered an IV bolus of 100 ml of iodinated contrast material. CT-CA was compared to CAG using a threshold for significant stenosis of >or=50%. The prevalence of disease demonstrated at CAG was 15% (1.4% in asymptomatic). The population at CAG showed no or non-significant disease in 85% (238/279), single vessel disease in 9% (25/279), and multi-vessel disease in 6% (16/279). Sensitivity, specificity, and positive and negative predictive values of CT-CA vs. CAG on the patient level were 100%, 95%, 76%, and 100% in the overall population and 100%, 100%, 100%, and 100% in asymptomatic patients, respectively. CT-CA proves high diagnostic performance in patients with or without symptoms and with zero CACS. The prevalence of significant disease detected by CT-CA was not negligible in asymptomatic patients. The role of CT-CA in asymptomatic patients remains uncertain.
authors: Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. filippocademartiri@hotmail.com
authors: Filippo
authors: F
authors: Cademartiri
authors: Erica
authors: E
authors: Maffei
authors: Alessandro
authors: A
authors: Palumbo
authors: Chiara
authors: C
authors: Martini
authors: Sara
authors: S
authors: Seitun
authors: Carlo
authors: C
authors: Tedeschi
authors: Roberto
authors: R
authors: De Rosa
authors: Teresa
authors: T
authors: Arcadi
authors: Ignazio
authors: I
authors: Salamone
authors: Alfredo
authors: A
authors: Blandino
authors: Annick C
authors: AC
authors: Weustink
authors: Nico R
authors: NR
authors: Mollet
authors: Pim J
authors: PJ
authors: De Feyter
authors: Gabriel P
authors: GP
authors: Krestin
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult