title: Does coronary calcium scoring with a SCORE better predict significant coronary artery stenosis than without? Correlation with computed tomography coronary angiography.
abstract: OBJECTIVE
  To determine effectiveness of coronary artery calcium score (CACS) alone and combined with Systematic Coronary Risk Evaluation (SCORE) in adult patients for significant coronary artery stenosis by using computed tomography coronary angiography (CTCA) as reference standard.
  
  
  METHODS
  Two thousand twenty-one patients with suspected coronary artery disease (CAD) underwent CACS test and CTCA. Patients were examined with dual-source CT and were grouped according to their age, gender, CACS, and estimated SCORE risk. Coronary plaque existence and degree of stenosis were assessed with CTCA. Sensitivity, specificity, and ROC curves were analyzed.
  
  
  RESULTS
  CACS was the single independent variable in estimating relative risk of critical stenosis and had superior outcome when compared with SCORE risk in logistic regression and ROC curve. Area under the ROC curve was greatest in the interval between 50-59 years. When SCORE was combined with CACS in patients with zero CACS, percentage of significant stenosis increased from 1.4% to 7.0% in patients with high or very high SCORE risk, and decreased to 0.9 % in patients with low or moderate SCORE risk.
  
  
  CONCLUSIONS
  CACS combination with SCORE risk predicts coronary artery stenosis. When CACS is zero, CTCA can be performed in patients with high or very high SCORE risk.
authors.affiliation: Department of Radiology, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: Gamze
authors.initials: G
authors.lastname: Durhan
authors.forename: Tuncay
authors.initials: T
authors.lastname: Hazırolan
authors.forename: Hamza
authors.initials: H
authors.lastname: Sunman
authors.forename: Jale
authors.initials: J
authors.lastname: Karakaya
authors.forename: Muşturay
authors.initials: M
authors.lastname: Karçaaltıncaba
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Ergun
authors.initials: E
authors.lastname: Karaağaoğlu
authors.forename: Deniz
authors.initials: D
authors.lastname: Akata
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods / Q000592:standards; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D012015:Reference Standards; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards; D061205:Vascular Calcification / Q000000981:diagnostic imaging*