Original articleClinical utility of coronary calcium scoring after nonischemic myocardial perfusion imaging
Section snippets
Methods
The study population included patients without known CAD who had undergone diagnostic MPI and were then referred by their physician for CAC screening by MDCT in close temporal proximity. All patients were seen at Cardiovascular Consultants and the Mid America Heart Institute, Kansas City, Mo, and were identified by a retrospective review of the databases at our center. Subsequent follow-up was obtained by review of medical records.
Results
Of the 200 patients in the study, 73 (36.5%) were men; the mean age was 54.7 ± 13 years; and 96% had 2 or more cardiac risk factors. Important clinical and stress test characteristics of the study population are listed in Table 1. The coronary calcium score was normal (Agatston score = 0) in 108 patients, minimally abnormal (>0–10) in 27, mildly abnormal (>10–100) in 30, significantly abnormal (>101–400) in 22, and severely abnormal (>400) in 13 (Figure 1).
Table 2 shows the comparison of
Discussion
This is first study to specifically examine the clinical utility of CAC scoring after MPI. We found that in patients who had a normal MPI study who were referred by their physician for coronary calcium scanning, 17.5% were reclassified as having significant CAD based on a CAC score greater than 100. Physicians seemed to incorporate the additional coronary calcium score data in the management of these patients. Of patients who had a normal MPI study and a CAC score greater than 100 (and were
Acknowledgment
The authors have indicated they have no financial conflicts of interest.
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