title: Predictive values of Framingham risk and coronary artery calcium scores in the detection of obstructive CAD in patients with normal SPECT.
abstract: A subgroup of patients with normal stress myocardial perfusion imaging (MPI) have obstructive coronary artery disease (CAD) on coronary computed tomographic angiography (CCTA). A retrospective study was performed to identify factors associated with obstructive CAD in patients with normal MPI. Bivariate differences between patients with obstructive (>50% stenosis) and nonobstructive (<50% stenosis) CAD were assessed. Of the 105 patients with normal MPI, 42 (40%) had obstructive CAD on CCTA. After a multivariable logistic regression analysis increased Framingham risk scores ([FRS] ≥10%) and coronary artery calcium scores ([CACS] >100 Agatston Units [AU]) were independently associated with obstructive CAD (P = .006 and P < .0001, respectively). Patients with normal MPI had 13 times and 98 times higher odds of having obstructive CAD if they had a FRS ≥10% versus <10% and CACS >100 AU versus ≤100 AU, respectively. Increased FRS and CACS may stratify patients who may benefit from further evaluation for significant CAD despite normal MPI.
authors.affiliation: Division of Cardiology, San Jose Medical Center, Kaiser Permanente, San Jose, CA 95119, USA. james.j.jang@kp.org
authors.forename: James J
authors.initials: JJ
authors.lastname: Jang
authors.forename: Ashok
authors.initials: A
authors.lastname: Krishnaswami
authors.forename: Yun-Yi
authors.initials: YY
authors.lastname: Hung
mesh_terms: D002114:Calcinosis / Q000175:diagnosis*; D002118:Calcium / Q000032:analysis*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D002118:Calcium