title: Coronary artery calcium score and CT angiography in asymptomatic elderly patients with high pretest probability for coronary artery disease.
abstract: OBJECTIVE
  To evaluate the role of coronary artery calcium scoring (CACS) and/or coronary CT angiography (CCTA) in asymptomatic elderly patients with high pretest probability for coronary artery disease (CAD).
  
  
  METHODS
  Forty-eight consecutive asymptomatic elderly (>65 years) subjects who had a high pretest probability and underwent CACS/CCTA were included. Each CCTA was evaluated for adequacy for assessment of coronary stenosis. Significant stenosis (>50% diameter narrowing) was assessed on evaluable CT images and by invasive catheter angiography (ICA).
  
  
  RESULTS
  All subjects were men with mean CACS of 880 ± 1779. Among those with low (0-99), intermediate (100-399), and high (400-999) CACS, ICA-verified significant stenosis was present in 8% (1/13), 23% (2/13), and 67% (8/12), respectively. Among those with very high CACS (≥ 1000) (n = 10), 90% of CCTAs were not evaluable for stenosis.
  
  
  CONCLUSIONS
  In asymptomatic elderly subjects with high pretest probability, CACS followed by CCTA may be considered for those with intermediate to high CACS.
authors.affiliation: Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Imanzadeh
authors.affiliation: Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: George
authors.affiliation: Department of Cardiology, Takase Clinic, Takasaki, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of Cardiology, Takase Clinic, Takasaki, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Takase
authors.affiliation: Department of Radiology, Takase Clinic, Takasaki, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Amanuma
authors.affiliation: Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA.|Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Rybicki
authors.affiliation: Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA. k-kumamaru@juntendo.ac.jp.|Department of Radiology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. k-kumamaru@juntendo.ac.jp.
authors.forename: Kanako K
authors.initials: KK
authors.lastname: Kumamaru
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging*; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted
keywords: Coronary CT angiography; Coronary artery calcium scoring; Coronary artery disease; Elderly