Coronary artery calcification deter...

Coronary artery calcification determined from electron beam computed tomography correlates well with coronary atherosclerosis. Quantitative techniques, chiefly notably the Agatston calcium score (ACS), have been give an inkling ofed but have limited reproducibility. Serial imaging not long ago has been recommended by the American guild of Cardiology/ American Heart Association Task Force to improve the predictive value. The volumetric calcium scoring (VCS) algorithm measures calcium by means of volume and compares the inferences with statistics from a population without coronary artery disease (CAD). The VC algorithm provides minimal interscan variability and allows for monitoring of CAD progression and regression secondary to medical therapy. Knez and associates used a prospective cogitation of symptomatic patients to determine the positive predictive value of the VC algorithm and the traditional ACS for significant CAD.

More than 2000 symptomatic adults with no history of CAD were included in the thought Most of them had chest pain, and one had unexplained exertional dyspnea or congestive heart failure. Coronary angio graphy was performed forward all participants; lumen diameter stenosis of 50 percent or more was defined as significant CAD. Total calcium scores were significantly different in patients with and without CAD. However, the best sensitivity and specificity were obtained with the VC algorithm, using a cutoff of at least the 75th percentile. The ACS mode was not as accurate as the VC algorithm. Patients with no coronary calcifications had a real low risk of CAD, giving the calcium score a high negative predictive value.

The authors infer that calcium scoring is a useful screening proof for CAD in symptomatic patients, with an accuracy similar to that of exercise/pharmacologic stres scintigraphy or echocardiography. Calcium scores may be useful in predicting high-risk stenosis, including triple-vessel and left-main disease. Calcium scoring eventually may be used to decrease the oftenness of invasive procedures that do not lead to intervention.

Knez A, et al. Relation of coronary calcium scores by way of electron beam tomography to obstructive disease in 2115 symptomatic patients. Am J Cardiol May 1 2004;93:1150-2

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